Explain why revenue cycle management is important and what the role for HIM professionals is in the process. Use a minimum of 3 sentences
1. The functions of the Charge Description Master (CDM) include producing an itemized statement of services received by a patient during a healthcare encounter, assigning charges to services and supplies, monitoring the cost of care, and providing cost accounting data to financial systems. Most errors are not the result of inaccurate CDM but rather a disconnected charging process. As the CFO of Healthcare Hospital, you are tasked with finding ways to prevent the following areas of common charging and coding errors. Address the following situations in your facility.
2. The following table is a sample of a section of the CDM for your hospital. After and audit you determine that for inpatient procedures, coders use ICD-10-PCS codes but the CDM uses CPT or HCPCS codes to determine charges for procedures. There is no link in the CDM between CPT or HCPCS codes and ICD-10-PCS codes. What should you do to correct this?
DEPT REVENUE MEDICAID DESCRIPTION ITEM NUMBER NUMBER 791002 481 CORONARY ARTERY DILATION INJECTION, CARDIAC CATH NURSING FAC CARE SUBSEQ HOME VISIT NEW PATIENT 92982 92982TC 761 761 $1,550.00 DB00.4601 481 93540TC 0800.4601 91000 761001 220.00 93540 9307 636 761 $75.00 0800.4601 761002 99341 56 610 761 |761 |761 0800 4601 800 4601 に800 46 01 $ 80.00 |REPAIR EYELID DEFECT |REPAIR EYELID DEFECT REMOVAL OF KIDNEY STONE |DECALCIFY TISSUE CHROMOSOME COUNT ADDITIONAL ASSAY OF FREE THYROXIE ASSAY OF THYROID ACTIVITY ASSAY THYROID STIM HORMONE 751003 810003 810004 | $ 110 CO|57915 | S 55000 |67916 0080 |636 |272 [7610 r610 272 7610 S 390.00 761 1761 D800,4501 D900 4001 モ10050 $2.065.00 88311 8285 610 610 10061 百10072 810080 791004 761 761 761 761 275.00 $159.00 $7,064.00 650.00 64439 34442 84443 272 622 272 272 610 610 7510 0800 4601 0800.4601 0800 4601 0800.4601
b. The billing department employees do not have systems in place to check for inaccurate charges. What procedures should be put in place to correct this?
c. The laboratory department CPT codes for tests are hard-coded into the laboratory electronic system and sent directly to the claim form, by-passing the CDM. What should be done to correct this?
3. Managing the Revenue cycle process: Explain why revenue cycle management is important and what the role for HIM professionals is in the process. Use a minimum of 3 sentences
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