Nursing
Question 1: Reimbursement and the Revenue Cycle
A. Define reimbursement and describe what reimbursement means to a healthcare organization. What would happen if services were provided to patients, but no payments were received for these services?
B. Illustrate the revenue cycle using a flowchart tool. Using a patient visit as an example, take the patient through the cycle from the initial point of contact through the care and ending at the point where the payment is collected.
C. .As you are describing the patient visit and going through the revenue cycle, identify the different departments that the patient will encounter. After identifying the departments, I want you to prioritize the departments at the healthcare organization you have chosen in order of their importance to the revenue cycle. Support your ordering of the departments with evidence.
Question 2: Departmental Impact on Reimbursement
A. In part one you identified and prioritized the different departments in order of importance to the revenue cycle, in part two assess the activities within each department at this healthcare organization and how each department may impact reimbursement.
B. Of the departments mentioned above which ones utilize reimbursement data? How do these departments impact reimbursement data? What type of audit would be necessary to determine whether the reimbursement impact is fully reached by these departments? How could the impact of these departments on pay-for performance incentives be measured?
C. Identify the responsible department for ensuring compliance with billing and coding policies. How does this affect the department’s impact on reimbursement at this healthcare organization?
Word Count: 250 Words Per Question
