What Is Healthcare Revenue Cycle Management?

Running head: REVENUE CYCLE & REIMBURSEMENT 1
Revenue Cycle and Reimbursement in Health Care System
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REVENUE CYCLE & REIMBURSEMENT 2
Revenue Cycle and Reimbursement in Health Care System
Revenue cycle and reimbursement are vital financial aspects that help in the
functionality of a health care organization. The following sections of the paper will briefly
discuss the revenue cycle and reimbursement, their integration in the healthcare system and
purpose.
Reimbursement
An extremely complex financial framework concerned with the collection of payment
for services in health care organizations is known as a reimbursement system. One of the
most critical issue that the health care organizations have to face regarding the reimbursement
system is the frequent change in the guidelines by the concerned governments. A variety of
reimbursement plans is offered by the health insurance payers, which includes a collection of
payment before or at the point-of-service, which is an essential challenge for the revenue
cycle management in the healthcare organizations (Whedon et al., 2017).
Revenue Cycle
Every health care organization’s stability and functionality is highly influenced and
determined by its revenue cycle, which is an all-encompassing combination of the processing
of claims, their payment and generation of revenue. The collection and management of the
revenue generated from patient service and its associated clinical and administrative function
is a brief overview describing the revenue cycle in health care organizations (Fredrickson,
2020).
To ensure that the organization is collecting the highest limit of possible revenue for
their provision of service, is improving efficiency in the revenue collection and management
and examining potential weaknesses in the financial management, it is vital that a theoretical
breakdown of the complex revenue cycle is performed, which will critically help in better and
in-depth understanding.