I. Reimbursement and the Revenue Cycle
a. Describe what reimbursement means to a healthcare organization. What would happen if services were provided to patients but no payments
were received for those services?
b. Illustrate the flow of the patient through the cycle from the initial point of contact through the care and ending at the point where the payment
is collected. Also identify the departments in order of importance to the revenue cycle.
II. Departmental Impact on Reimbursement
a. Describe the impact of the departments in a healthcare organization that utilize reimbursement data. What type of audit would be necessary to
determine whether the reimbursement impact is reached fully by these departments? How could the impact of these departments on pay-forperformance incentives be measured?
b. Assess the activities within each department in a healthcare organization for how they may impact reimbursement. What specific data would
you review in the reimbursement area to know whether changes were necessary?
c. Identify the responsible department for ensuring compliance with billing and coding policies. How does this affect the department’s impact on
reimbursement in a healthcare organization?
