Prepare a revenue cycle plan for a community hospital. Include the following information in your plan:
- Evaluation of clinical data required for payment and reimbursement systems (PPS, DRG, RBRVS, RUGs, VBP, Billing/insurance plans).
- Explanation of chargemaster and claims management applications and processes.
- Assess the effect on healthcare finance of revenue management (cost reporting, budget variances).
- Summarize revenue cycle management and reporting processes (CCI, X12N).
- Evaluation of the severity of illness and how it impacts the healthcare payment systems.
The format of this plan is like a policy and procedure but is a longer document. Compile your document based on the findings and collection of information for each of the requirements.
Domain IV. Revenue Cycle Management
IV.3. Evaluate compliance with regulatory requirements and reimbursement methodologies.