Revenue Cycle Plan

Prepare a revenue cycle plan for a community hospital.  Include the following information in your plan:

Introduction

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 effect on healthcare finance of revenue management (cost reporting, budget variances).
• Summarize revenue cycle management and reporting processes (CCI, X12N).
• Evaluation of 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.
• Recommended Text(s):

Mosby, I. (2009). Mosby’s Dictionary of Medicine, Nursing & Health Professions (8th ed.). St. Louis, Mo.: Mosby/Elsevier.

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