Information Sheet: Compliance Revenue Cycle Process Flow (Essay Sample)

Information Sheet: Compliance Revenue Cycle Process Flow Name Institution Course Professor Date Compliance Revenue Cycle Process Flow Three Considerations for a Compliant Revenue Cycle With at Least Two External Governing Bodies (e.g., Oig) Included in the Considerations A revenue cycle management strategy is highly beneficial for any healthcare organization or provider because it allows them to collect timely payments from patients and insurance companies (Jewell, 2019). Happyville Health System aspires to create compliance within its revenue cycle management that guarantees success through continuous revenue generation. It is integral to maintain a highly transparent and communicative revenue cycle. Accrual denotes that the organization acknowledges revenue when it is generated and not necessarily when it is received through cash or bank transfer or other alternative methods. Conversely, cash is utilized when the organization only recognizes revenue when the amount is received. Once the mode of recognizing revenue is established, the following action denotes the mode through which payments to Happyville are received. The next phase is creating the authority matrix for the organization. The authority matrix highlights the respective designations of personnel working for the organization and the limits within which they can approve payments or outflows. The authority matrix aids in highlighting discrepancies. It is paramount to ensure that Happyville Health System adheres to the various standards set out for organizations by the OIG. It includes ensuring the billing, coding and documentation processes abide by the HIPAA, ACA, FCA and payer-specific policies. Five Thresholds or Indicators that Establish Healthcare Compliance Written policies or codes of conduct outline the expectations of the compliance program. The code of conduct should stem from the code of ethics utilized or created by Happyville Health Systems. A compliance officer and oversight team should be in place (Jewell, 2019). The best practice would be for the compliance officer to report directly to the CEO and board of directors of Happyville Health Systems. Happyville employees should receive extensive training, education, and guidance on general compliance issues and the new measures. The educational or training programs should touch on fraud, waste, the Anti-Kickback Statute, waste and False Claims Act, inappropriate gifts, and relationships with referral resources. The reporting hotline enables individuals within or outside the organization to report on compliance issues freely. The hotline should ideally be toll-free numbers and mailbox addresses that foster a cu...