Question

Revenue represents amounts earned by an organization: that is, actual or expected cash inflows due to the organization’s major business. In the case of health care, revenue is mostly earned by rendering services to patients. Revenue flows into the organization is sometimes referred to as the revenue stream.

Step 1

·        Review the following key terms:

o   Discounted Fee-for-Service

o   Fee-for-Service

o   Managed Care

o   Medicaid Program

o   Medicare Program

o   Payer Mix

o   Revenue

Step 2

·        Review Chapter 4

·        Review PowerPoint

·        Complete Assignment Exercise 4–2: Revenue Sources and Grouping Revenue   (Found in the back of your textbook pp 463.)

Answer 1

• Discounted fee-for-service-it is a financial reimbursement system in which the health care provider provide services to the client on a fee for service and later a percent of fees is deducted from the physicians customary charges.
• Fee for services are unbundled services and paid for separately .This is a payment model which is volume driven ,in which the physicians recieve an incentive for providing treatment to more patients.
• Managed care mainly focus on improving quality care rather than quantity and through managed care they provide group actitvities to reduce the cost and at the sametime improve quality care.
• Medicaid program is a health care program which provides health insurance to low income families.
• Medicare program is a federal health insurance program for senior citizens ,younger people with disabilities and for people with End Stage Renal disease.
• Payer mix-it is used for detrmining the percentage of revenues coming fro both public and private sectors and compares with self-paying individuals.
• Revenue is the sum total of all administrative and clinical functions which contribute to management and collection of patient service revenue.

2.No information given about the content in pp 463