Human Resource Management Coding
Assignment Instructions
Prepare a revenue cycle plan for a community hospital. Include the following information in your plan:
Introduction
Evaluation of clinical data required for payment and reimbursement systems (PPS, DRG, RBRVS, RUGs, VBP, Billing/insurance plans).
Explanation of chargemaster and claims management applications and processes.
Assess effect on healthcare finance of revenue management (cost reporting, budget variances).
Summarize revenue cycle management and reporting processes (CCI, X12N).
Evaluation of severity of illness and how it impacts the healthcare payment systems.
The format of this plan is like a policy and procedure but is a longer document. Compile your document based on the findings and collection of information for each of the requirements.
Grading Rubric
Assignment 2: Revenue Cycle Plan
Points
Plan includes an evaluation of: Clinical data required for payment and reimbursement systems (PPS, DRG, RBRVS, RUGs, VBP, Billing/insurance plans
15
Plan includes explanation of: Chargemaster and claims management applications and processes.
15
Plan includes assesses: Effect on healthcare finance of revenue management (cost reporting, budget variances).
15
Plan includes summary of: Revenue cycle management and reporting processes (CCI, X12N).
20
Plan includes evaluation of: Severity of illness and how it impacts the healthcare payment systems.
15
Plan is comprehensive and written in a policy and procedure format, based on findings and collection of information
20
Total
100 points
This assignment will assess the following CAHIIM Competencies:
Domain IV. Revenue Cycle
Subdomain IV.A. Revenue Cycle and Reimbursement
Manage the use of clinical data required by various payment and reimbursement systems
Take part in selection and development of applications and processes for chargemaster and claims management.
Apply principles of healthcare finance for revenue management.
Implement processes for revenue cycle management and reporting.
Domain V. Compliance
Subdomain V.B. Coding
Identify severity of illness and its impact on healthcare payment systems.
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