Every healthcare organisation, from clinics to national networks, needs well-oiled financial mechanisms to continue doing what they do best: saving lives and healing patients. This is where hospital billing revenue management comes into play. The term “Healthcare Revenue Cycle Management” refers to the financial process that is used by facilities to handle the administrative and clinical activities related to the processing of claims, the payment of claims, and the creation of revenue.

Patient appointment scheduling marks the beginning of hospital billing revenue management. Once organisations have collected all patient payments and claims through the medical billing process, the procedure is considered complete. However, the actual life of a patient’s billing revenue management is not nearly as simple as it may first appear. First, when a patient makes an appointment, the administrative team is responsible for setting up the patient’s account, verifying the patient’s insurance, and scheduling the appointment. The optimisation of the operations that govern the revenue cycle relies heavily on pre-registration. During this stage of the billing revenue management process, staff members build a patient account by compiling information about the patient’s medical history and insurance coverage. Twyla Technology’s CloudClinik is an EMR and a Practice Management System that helps maintain Healthcare Revenue Cycle Management.

After seeing a patient, medical professionals are responsible for the medical billing process, creating the submission of a claim and performing charge capture for billing revenue management. The ICD-10 code that correlates with the therapy is identified by the provider or coder, which determines how much payment the entity will get from the patient’s health plan. Claim denials can be avoided by using the correct service coding during the medical billing process with CloudClinik. Services rendered and associated charges are recorded and made chargeable in the charge capture procedure of CloudClinik, making the whole process effortless.

Once a claim has been prepared, the medical facility will submit it to the applicable private or public payer for payment. However, the management of the revenue cycle for healthcare systems does not conclude there. Claims reimbursements involve a number of administrative processes that businesses must still monitor, such as payment posting, statement processing, payment collections, and claim denials. Depending on the patient’s coverage and payer contracts, healthcare organisations may be reimbursed for their services when an insurance company reviews the claim. Claim denials can occur for many reasons, including incorrect coding, missing data in the patient’s chart, and faulty medical billing process. Healthcare providers have a legal obligation to inform patients and collect payment for any expenses their insurance does not cover.

Health information technology and electronic health record systems like CloudClinik have improved the effectiveness of hospital billing revenue management. Technology is used by many Healthcare providers to monitor claims, collect payments, deal with claim denials, and billing revenue management. These advancements, in the end, make it possible to have a steady flow of money. Healthcare providers have benefited from automation in areas like payer-provider communications, ICD-10 code recommendation, medical billing process monitoring, and appointment scheduling. Innovations like CloudClinik are the future of healthcare.

Value-based healthcare, advances in healthcare technology, and the threat of a worldwide pandemic are just a few examples of the ways in which hospital billing revenue management is changing at a rapid pace. In order to offer appropriate treatment to patients and to receive adequate reimbursement for services rendered, healthcare personnel should always be informed of the hospital billing revenue management system. CloudClinik is just the tool to make that happen for healthcare providers.