Milestone 3.docx - Running Head MILESTONE THREE 1 Mary Smith 5-2 Milestone Three Draft of Billing Marketing and Reimbursement Southern New Hampshire

Milestone 3.docx - Running Head MILESTONE THREE 1 Mary...

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Running Head: MILESTONE THREE 1 Mary Smith 5-2 Milestone Three: Draft of Billing, Marketing, and Reimbursement Southern New Hampshire University
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MILESTONE THREE 2 Draft of Billing, Marketing, and Reimbursement For MHG, the revenue cycle is an essential part of the reimbursement process. The different parts of the revenue cycle are responsible for specific roles that aid in the submission of a claim for reimbursement of services rendered. During the first part of the revenue cycle, the front-end process, patient access personal collect patient data. Patient access personal is responsible for registration, scheduling, insurance verification, requesting and receiving preauthorization (before patient receiving the treatment), collecting patient demographics, and financial counseling and patient responsibility (Harrington, 2016). The information collected by patient access is used in the billing and coding parts for the revenue cycle. Because of this, the data gathered needs to be accurate so that claims are not denied causing a financial burden on MHG. The tasks that patient access is responsible for, “decreases the time spent creating bills, reduces patient debit balances, collection of revenue is fasters, and reduces bad debt expenses by insuring accounts will be paid in full” (Rauscher, Wheeler, & Hilleary, 2008). Since the patient access department deals with every patient that comes into MHG, it is an essential part of the billing and collection process and the workflow of MHG. Due to the department's interactions with patients, they must provide exceptional customer service. When a patient comes into MHG, it is not because they want to, it is because they need to. Typically, a patient has a lot of anxiety due to not knowing their outcome and the cost of care. Having exceptional customer service can help to relieve their stress and "make or break" their experience (Lecture 1.1, n.d.). Also, because the department needs to collect personal information from the patients, showing them respect and being friendly will allow the process to run smoother. Not only will the process run smoother, providing exceptional customer service helps the patient feel comfortable. Finally, providing outstanding customer services helps MHG stand out from other healthcare organizations. When
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MILESTONE THREE 3 their patients need care again, they will more than likely return to MHG due to their experience. The patients who have exceptional experiences might refer MHG to others seeking care. Thus, providing excellent customer service helps with bringing in patients, which in return allows MHG to provide quality care and improve the health of the community. Third-party policies will be used to determine MHG's payer mix to make sure they are receiving maximum reimbursement. MHG needs to make sure that they are not relying on a few payers to be financially stable. For instance, if they rely on Medicare and private payors only, what would happen if there was a glitch in Medicare's system, and they did not get paid for services rendered on certain days? The private payors tend to cute their payments, which leads to
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