Revenue Cycle

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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.

Posted in: Definitions

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