Revenue Cycle Plan for a Community Hospital

KMTC Community Hospital Revenue Cycle Plan
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Introduction

This revenue cycle plan will be the backbone of the financial operations in the hospital. It is designed to ensure a seamless flow of financial information from all patients from the moment they contact the hospital to reimbursement. It is designed to ensure a smooth operational framework for different interconnected processes aimed at revenue generation, compliance with diverse payment systems and enhancing customer satisfaction. The plan is largely derived from revenue cycle management proposed by  (Manley & Satiani, 2009). Each stage of the revenue cycle from pre-registration, registration, charge capture, claim submission, remittance, insurance follow-ups, and patient collections will be meticulously done to ensure accuracy, precision and financial integrity. This plan is designed to be aligned with different payment and reimbursement systems (PPS, DRG, RBRVS, RUGS, VBP, billing/insurance plans) alongside detailed procedures for evaluating clinical data, managing chargemasters, claims, and assessing healthcare finance implications. It also encompasses nuances of severity of sickness and reporting processes such as cci, x12n to ensure compliance in revenue cycle management. The aim of our hospital it to establish a robust, reliable and effective financial framework that not only maximizes revenue collection, but also is transparent and simple enough for our staff and patients. It is designed to foster trust, clear communication especially on financial expectations by the patients and ethical collection and reimbursement practices.
Preregistration policy and procedure
The main objective of this process to ensure that all the necessary patient information and insurance details are captured in real-time. This