CRCR
Unit
1
Review
The
3
patient-centric
revenue
cycle
processing
steps
-
ANSPre-service,
time-of-service,
post-service
Pre-service
steps
-
ANSPatient
scheduled
and
pre-registered,
encounter
record
generated,
patient
and
guarantor
information
is
obtained,
medical
necesity-health
plan
coverage
verified-pre-auth,
cost
of
service
determined,
additional
processing
for
not
medically
necessary
procedures,
explanation
of
patients
financial
responsibility
Time
of
service
steps
-
ANSPatient
arrives
and
pre-registered
information
is
pulled
up.
Consents
signed
and
amounts
collected.
Positive
ID
completed
and
armband
given.
Post
service
steps
-
ANSAfter
the
patient
is
discharged
until
the
account
reaches
a
zero
balance
such
as
final
coding,
prep
and
submission
of
claims,
payment
processing
and
balance
billing
What
happens
during
the
post-service
stage?
-
ANSFinal
coding
of
all
services,
preparation
and
submission
of
claims,
payment
processing
and
balance
billing
and
resolution.
What
happens
during
the
pre-service
segment?
-
ANSScheduling
and
pre-access
processing
is
completed.
The
patient
is
scheduled,
pre-registered
for
service
and
the
required
data
is
collected.
What
happens
during
time-of-service
segment?
-
ANSFinal
account
review
is
completed
for
a
scheduled
patient
prior
to
arrival.
Upon
arrival,
patient
is
positively
identified,
pre-registration
record
activated,
consents
are
signed,
copays
collected.
What
is
done
at
time-of-service
for
unscheduled
patients?
-
ANSComprehensive
registration
and
financial
processing
is
completed
which
mirrors
the
work
that
was
completed
for
scheduled
patients.
3
components
to
Healthcare
Dollars
and
Sense
Revenue
Cycle
initiative?
-
ANSMedical
Account
Resolution,
Pricing
Transparency,
Patient
Financial
Communications
When
is
it
appropriate
to
discuss
financial
items
for
a
ED
patient?
-
ANSAfter
the
patient
has
been
stabilized
or
during
the
discharge
process.
As
long
as
it
does
not
interfere
with
the
patients
care.
What
is
the
objective
of
the
HCAHPS
initiative?
-
ANSTo
provide
a
standardized
method
for
evaluating
patients'
perspective
on
hospital
care.
Examples
of
a
continuum
of
care
provider?
-
ANSSkilled
Nursing
Facility,
Physician,
Hospice
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