MHA FPX 5006 Assessment 2 Revenue and Reimbursement If you need any help in this assessment “MHA FPX 5006 Assessment 2 Revenue and Reimbursement,” we will assist you.

The revenue cycle for the healthcare sector starts with pre-registration and ends with final payment in exchange for the services (Levinson et al., 2022). The stages of the revenue cycle include:

1. Preregistration

Preregistration is the first stage of the cycle where the healthcare practitioners collect important information about the patient when he/she is on the phone call. This information includes insurance eligibility, demographics, and other data. The insurance provider verifies information including the patient’s coverage, insurance amount, and referrals. Through the preregistration process, payment-related worries are taken care of, and practice can set the financial tone immediately. With a stringent preregistration process, many elements might be noticed in practice. Examine your preregistration process to launch your revenue cycle (Rosenfeld, 2019).

1. Registration

By registering, you can ensure that all patient info is accurate and truthful. When the patient registers, the provider confirms the patient’s address, phone number, date of birth, guarantors, and insurance information. Each time a patient is treated, they are required to protect this information. Co-payments are required at the time of registration. If the patient is being treated by a specialist, an authorization or referral may be required to start the treatment. If that step is included at the office, the expert will likely get paid for their services. Leaving these steps out and having the practice audited might have financial repercussions. If you need further assurance, consult a professional to review your registration process. By ensuring that step two of the revenue cycle process is precise and thorough, long-term problems may be avoided (Carney, 2021).

1. Charge Capture

Charge capture is the 3rd stage of the cycle which can be done in multiple ways. Automation is a choice where information from the provider’s paperwork is utilized to flow automatically into the billing side of practice management. The option is for front desk staff to input the data manually or to forward it to billing, where it is manually entered. Both approaches have advantages and disadvantages, and certain fees can be missed depending on the approach. One. Making sure your charges are properly recorded is a crucial stage in the revenue cycle (Carney, 2021).

MHA FPX 5006 Assessment 2 Revenue and Reimbursement

If you need any help in this assessment “MHA FPX 5006 Assessment 2 Revenue and Reimbursement,” Do My Course will assist you.

4. Claim Submission

Once the charges have been made, sending information to the insurance provider is part of the claim filing procedure. The team working on the revenue cycle examines CPT, charges, and diagnostic codes. They will ask whether the diagnosis supports the course of action. When two services are provided, they must be separated and appropriately categorized. Claim cleaning is the process of cleaning up claims before submitting them. If a claim is received by the insurance provider undamaged, it will be resolved considerably more quickly. During the process, all the claims are sent to the clearinghouse from the practice management system. The clearinghouse accepts the claims and then sends the claims to multiple payers. While the transmission report shows claims that have been sent, gotten feedback, and been deleted, the rejections report highlights incorrect codes (Carney, 2021). 

1. Remittance Processing

Remittances will be given to a practice after the processing of its claims. The benefits explanation describes how much the practice paid for the services. The service contract provisions between the provider and the insurance company are acceptable. The insurance company provides complete information about the payment for each service.

 A common mistake made throughout remittance is “post and go.” Electronic posting has become more prevalent in the revenue cycle. Consequently, a practice can have problems if they send remittances and never look at them again. In the “publish and go” scenario, there is a possibility that the issue can go unreported. I.e. there may be some error in the practice management system or the carrier may not pay. If no one examines the method or the reports, a practice may need to pay greater attention to the likelihood of an appeal and, therefore, the capacity to fix a mistake.

Remittances often include fee schedules or providers’ prices for each service. Providers should review their charge schedules annually to re