Technology and the Revenue Cycle Process Assignment
Innovations in technology have impacted every aspect of health care, from the way in which patients seek their providers, to how organizations market themselves, to how claims are submitted to insurance companies for payment. Many of the non-clinical innovations focus on data collection and using the data for meaningful purposes, including billing and revenue cycle.
For your initial post, identify a technological innovation, such as electronic health records, billing software, estimator tool, et cetera. In your response, address the following:
- Describe the technological innovation you selected.
- What role does it play in the revenue cycle process?
- Outline the process prior to the innovation.
- What are the implications for reimbursement for organizations not utilizing the innovation? Examples include delayed reimbursements, improper coding, reduced reimbursements, et cetera.
Describe the technological innovation you selected?
The medical billing structure is a complex system with the primary purpose of ensuring that healthcare providers are adequately reimbursed for their various services. Therefore, the development and implementation of the Electric Health Record increase the ability of practices to maximize their collections and thus, be more productive. This is a digital version of the patients’ paper charts(Stahl, 2004). Furthermore, it involves real-time, accurate, and patient-centred records that guarantee continuous availability of information that is only restricted to authorized personnel.
What role does it play in the revenue cycle process?
The revenue cycle process refers to clinical and administrative functions that contribute to the collection, capturing, and management of the patient service revenue. It guarantees the creation of an improved patient experience and proper collection of their information throughout the entire process of care. This technology enables health providers to have automated, standardized, and streamlines user workflow by increasing the speed and accuracy of data collection. Consequently, the verification of personal data has been hastening and thus the patient billing.
Outline the process prior to the innovation?
Prior to this form of innovation, the conventional methods of data collection for the majority of the health institutions were paper records. This involved the clinician utilizing a template and individual handwritings that were illegible. These unstructured documents lacked accuracy and could not be electronically stored or shared. Other shortcomings included the increased expenditure, difficulty in analyzing, and negative impact on the environment.
What are the implications for reimbursement for organizations not utilizing the innovation? Examples include delayed reimbursements, improper coding, reduced reimbursements, et cetera.
Health institutions that fail to utilize this technological innovation run the risk of decreased accuracy of documentation resulting in incomplete coding, and ultimately inaccurate, reduced, or delayed reimbursement claims. This is based on Sue Bowman, the senior director of compliance of the American Health Information Management Association and senior director of coding policy (Vancheri, 2011). This would be due to outdated and misleading information.
Vancheri, C. (2011). Innovations in health literacy research. Washington, D.C.: National Academies Press.
Stahl, M. (2004). Encyclopedia of health care management. Thousand Oaks, Calif.: Sage Publications.
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