Revenue Cycle

The revenue cycle for a medical practice is the process of collecting reimbursement for a provided service. Some of the common steps are:

1. Development of a “retail” fee schedule and a financial policy (payment practices.)
2. Negotiating and signing payer contracts to accept specific fee schedules for services.
3. Providing services to patients and collecting patient-responsibility portions at the time of service.
4. Posting charges for services rendered and billing payers (filing claims.)
5. Receiving payments from payers; appealing payments when not compliant with contracts.
6. Sending statements to patients for any remaining portions due.
7. Writing balances off the accounts receivable or sending patients to collection agencies/reporting agencies (credit bureaus) or pursuing legal action if patient payments are not made.