Question

Define and discuss the relationship between clinical documentation improvement, electronic document management, and revenue cycle management. Identify how efforts and operational focus of the first two affect revenue cycle and what those impacts could mean to the healthcare organization

Answer 1

Clinical documentation is very important in the healthcare setting which must be accurate, concise, and timely. It represents the patient's clinical data. Electronic Health record converts the data into an electronic form and the coded data of quality reporting, public health data, reimbursement, and disease prevalence.

Both the clinical documentation and the electronic documentation plays an important role in the revenue cycle process. Clinical documentation improves the identification, classification, and sorting of clinical data whereas the electronic medical records provide the patient information and access to data for coding, billing, and reimbursement. This will help to manage the revenue cycle more effectively.

The coding system of ICD-10 minimizes the workflow of the revenue cycle. EHR's facilitate the billing under different payment methods. If the EHR is not effectively used, then the payment mechanism will be distorted. The new payment strategies are not under the Revenue management cycle model. Clinical documentation compliance with the follow-up of the patient throughout the lifecycle. The patient should be tracked for the consultations, recommended procedures, patient condition and the refusal of treatment.

Revenue cycle should track the patient information and eligibility for the payment. The operational system focus on the relationship between the services and the payments. This will impact on the Healthcare Organization's features and other requirements. The organization facing challenges on the performance issues. They require to maintain different strategy and tool.