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Hcs 430 Week 3 Assignment

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1. Revenue Cycle
1.1. Who is responsible for revenue cycle functions? Describe each function by title.
The revenue cycle begins with patient access. Patient access is responsible for scheduling, registering patients, obtaining their demographics and insurance information as well as collecting out of pocket patient liability. The director of patient access is responsible for this portion of the revenue cycle's function.
Health information management (HIM) also plays a crucial role in the revenue cycle. The health information management department codes the accounts, enters charges, and ensures that documentation supports the services that were billed. The director of HIM oversees this area of the revenue cycle.
Lastly, patient financial services are part of the revenue cycle. Patient financial services ensure that claims are billed to the …show more content…
Their goal is 43 days in AR. Mercy Health Saint Mary's currently runs about 45 days. Whereas, Mercy Health Muskegon typically is around 40 days. They report as a region, which brings their region days in AR to 43.
4. Describe a payment system that includes contractual adjustments.
An example of their payment system that includes a contractual adjustment would be the following scenario. A patient has a $150.00 procedure done at Mercy Health. Mercy Health then bills the insurance the $150.00 charge, the insurance company allows $80.00 for the service. When the payment is received and posted to the account, the remaining $70.00 is considered a contractual adjustment. Mercy Health would then accept what the insurance allows for the service.
4.1. What is the system? How does it work? Provide an example.
The system used for accounts receivable is known as the Receivables Workstation. When payments are received for the services rendered, this system identifies the payer. The difference between the price of the service and the amount that the insurance pays is the contractual

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