Article | December 1, 2017

Financial Stability In A Fluid Market

Source: Health Language

By Beverly Holley, Health Language

Open Data Roundtables

Four Ways to Address Data Management Challenges and Strengthen Your Revenue Cycle

Revenue cycle management can leverage systems and workflows that close gaps, tie up loose ends, and ensure submission of a clean claim. Reference data—representing the coded and uncoded data used across a health system—plays an all-important role in strategies that optimize revenue cycle processes and ensure compliance with industry licensing requirements.

As the market continues to shift to greater focus on value-based care and risk-based contracts, healthcare organizations must rely on massive amounts of claims data for analytics to optimize revenue lines. Reference data standards such as CPT®, CDT®, HCPCS, ICD-10, UB-04®, and other proprietary or custom codes sit at the core of these strategies.

Keeping this content up to date is an enormous challenge for the resource-strapped revenue cycle department as codes are added and changed over time, or become obsolete. Consider the annual CPT challenge—within the upcoming Jan. 1, 2018 CPT and HCPCS update, there are:

  • 191 code changes to CPT and HCPCS
  • Over 1240 term changes that can impact the meaning of the codes
  • An addition of two modifiers to existing codes