“At the organizational level, hospitals and clinics need clinical, financial, and administrative data/information to measure, assess, control, and improve the quality and productivity of their operations” (Reid, P., Compton, D. W., Grossman, J. H., Fanjiang, G. 2005). Financial information is especially important for managing healthcare organizations. The primary use of financial information is evaluation of organization’s financial condition. The financial data can answer a question regarding achieving goals, the viability of the entity, and its solvency. Financial information aids in assessing the stewardship of the organization, effectiveness and efficiency of organization’s operations, as well as aids in measuring the compliance with budget
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Internal and external drivers influence the revenue cycle. Things like the productivity of the provider, the volume of patients and fees charged by the provider, are internal factors that can be controlled. On the other hand, things like patient payments, claims form payers and lengthy collections are more difficult to control and might take long time to be collected and often get written off and therefore decrease the cash flow. Efficient coding and billing system can positively impact revenues, on the other hand claims submitted to the payer late or missing the payer’s requirements or absence of claim, negatively impact the cash flow. Challenges with patients paying their deducible and copays along with complex insurance claims filling, influence the practice’s revenue. In a surge to lower costs of healthcare, policymakers, HCOs and practitioners focus on value, trying to deliver best health outcomes at a given cost level.
“In the United States, there are at least three major payers for health care: governments (Federal, State, and local); employers, through employer-based health insurance; and health care consumers themselves, through out-of-pocket payments” (CDC
Internal and external drivers influence the revenue cycle. Things like the productivity of the provider, the volume of patients and fees charged by the provider, are internal factors that can be controlled. On the other hand, things like patient payments, claims form payers and lengthy collections are more difficult to control and might take long time to be collected and often get written off and therefore decrease the cash flow. Efficient coding and billing system can positively impact revenues, on the other hand claims submitted to the payer late or missing the payer’s requirements or absence of claim, negatively impact the cash flow. Challenges with patients paying their deducible and copays along with complex insurance claims filling, influence the practice’s revenue. In a surge to lower costs of healthcare, policymakers, HCOs and practitioners focus on value, trying to deliver best health outcomes at a given cost level.
“In the United States, there are at least three major payers for health care: governments (Federal, State, and local); employers, through employer-based health insurance; and health care consumers themselves, through out-of-pocket payments” (CDC