Navigating the Healthcare Revenue Cycle

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NAVIGATING THE HEALTHCARE REVENUE CYCLE
A COMPREHENSIVE OVERVIEW
Introduction The revenue cycle healthcare is a
complex process that involves various stages and
stakeholders. This infographic provides a
concise overview of key elements in the
healthcare revenue cycle.

• Patient Registration
• Gather patient demographic and insurance
  information. Verify insurance eligibility.
• Ensure accurate data entry to prevent billing
  errors.
• Appointment Scheduling
• Efficiently schedule patient appointments.
  Minimize no-shows to optimize revenue.
• Eligibility Verification
• Verify insurance coverage and benefits. Confirm
  pre-authorization requirements.
• Point of Service (POS) Collections
• Collect co-pays and outstanding balances at the
  time of service.
• Improve upfront revenue capture.
• Medical Coding
• Assign accurate medical codes for procedures and
  diagnoses.
• Ensure compliance with coding guidelines (ICD-10,
  CPT).
• Charge Entry
• Enter billed charges for services provided.
  Cross-check with medical coding for accuracy.
• Claims Submission
• Transmit claims electronically to payers.
  Monitor claim status for timely processing.
• Denials Management
• Identify and address claim denials promptly.
  Appeal denied claims when necessary.