Quick Revenue Cycle

Quick Revenue Cycle Self-Assessment David D’Silva, chief operating officer for Park Ridge, Ill.-based Healthcare Information Services, recommended using the following checklist to assess your strengths and weaknesses in managing the revenue cycle. Collecting from patients: Do you have an effective process to obtain eligibility and collect copays, deductibles, and prior balances? Critical performance measures: Do you measure the revenue cycle in your practice to include charges, payments, adjustments, A/R aging, charge lag-time, gross collection percent, denial percentage, clean claim rate, and days in A/R? Denial management process: Do you know the top five reasons for insurance denials AND how to correct and prevent them? Optimal coding process: Do you have a coding process that maximizes revenue and compliance? Effective appeals process: Do you have a structured and effective appeals process? Maximize the use of electronic payments: Do your payers pay you via an electronic remittance advice or paper check? Effect of payer changes: Do you understand and forecast the impact that payer changes will have on your reimbursement? Payer contract compliance: Do you know if your payers are paying you according to your contracted reimbursement schedule