FOLLOW THE WORK FROM START TO FINISH
The revenue cycle, step by step.
Each stage receives information, makes a decision and passes the work forward. Open any stage to see what comes in, what should move next and the questions worth asking.
01Registration & coverage
- Comes in
- Scheduled encounter and patient-supplied details
- Goes forward
- Coverage information and unresolved questions routed to an owner
What does the next team still need to know?
03Documentation & coding
- Comes in
- Clinical record and current coding guidance
- Goes forward
- Supported service information and clarified uncertainties
Does the record support what is being reported?
04Claim preparation & submission
- Comes in
- Validated encounter, provider and payer information
- Goes forward
- A submission plus its acknowledgment
Was the claim actually accepted into processing?
05Adjudication & remittance
- Comes in
- Payer response and claim history
- Goes forward
- A reconciled explanation of payment and adjustments
What do the full response and applicable instructions say?
06Payment posting & reconciliation
- Comes in
- Remittance and payment records
- Goes forward
- Posted transactions and identified reconciliation differences
Do the payment, remittance and account records agree?
07Denials & outstanding balances
- Comes in
- Open balances grouped by cause and age
- Goes forward
- Supported action, accountable owner and review date
Which action can move this balance toward resolution?
08Review & prevention
- Comes in
- Recurring patterns and documented findings
- Goes forward
- A workflow or teaching change with a follow-up check
Which upstream handoff should change, and how will we check it?
Walk a sample encounter through the complete cycle with your team.
Practice onboarding checklist ↗