Traditional revenue cycle models, dividing processes into front (registration), middle (clinical documentation), and back (billing/collections), oversimplify the reality of interconnected functions. Modern healthcare demands a more holistic “web” view, especially with increasing patient consumerism. Key stages include:

  • Pre-registration: Collect accurate patient data, complete prior authorization, and ensure financial clearance
  • Point of service: collect patient payments for service, including copay or self-pay balances
  • Claim submission: Accurate coding and supporting documentation provided
  • Claim follow-up: Claim denials can occur for various reasons; timely follow-up is crucial for correction or appeal
  • Patient collections: Maintain accurate billing and follow-up to collect payments, transitioning to state-compliant collections for debts over 120 days


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