Revenue Cycle Management Glossary

Revenue received compared to adjusted charges.

Revenue cycle management glossary. By catherine sampson april 15 2016 in some cases definitions for terms and acronyms related to healthcare revenue cycle management can come across as fairly straightforward. Definition of the revenue cycle revenue is defined as financial income and the cycle is the regu larly repeating set of events that produces it. This is an optional step available prior to submitting an appeal. American medical association is a widely distributed medical journal in the world.

Revenue cycle management quantrax corporation inc page 1 1. Once set in a chargemaster charges are used in the management of the accounts receivable for the service provider. Often references to the healthcare revenue cycle can be vague or over broad and as a result this critical element of an organization s success can be oversimplified or misunderstood. Revenue cycle management self service glossary claim reconsideration request for unitedhealthcare to review a processed claim.

The healthcare financial management association hfma defines healthcare revenue cycle management as all administrative and clinical functions that contribute to the capture management and collection of patient service revenue. Consequently you cannot maximize collections at the cost of high numbers of complaints or minimize a r days at the cost of high bad debt or contractual write offs. Glossary american medical association ama the largest consortium of doctors in the us. Adjustment the portion of medical bill that doctor or hospital has agreed not to charge patient.

In a healthcare facil ity all administrative and clinical functions that contribute to the capture presentation and collection of patient service expenses comprise the revenue cycle. Revenue cycle management is the process used by healthcare systems in the united states and all over the world to track the revenue from patients from their initial appointment or encounter with the healthcare system to their final payment of balance. The cycle can be defined as all administrative and clinical functions that contribute to the capture management and collection of patient service revenue it is a cycle that describes and explains the life cycle of a patient through a typical. Glossary of frequently used billing and coding terms accountable care organization.

Revenue cycle management in healthcare is a financial process used by various facilities to manage the administrative and clinical relations that are associated with the processing of claims payment and revenue generation. The objective of the revenue cycle is to provide right product at right price at right place where the customer needs at the right time. Revenue cycle is a recurring business activities and information processing operations involved in the process of delivering goods and services to customers and receiving payments for the sales.