EHR's effect on the revenue cycle management Coding function

J Healthc Inf Manag. 2008 Winter;22(1):26-30.

Abstract

Without administrative terminologies there is no revenue to manage. The use of healthcare IT to capture the codes for administrative and financial support functions will impact the revenue cycle and the management of it. This is presumed to occur because clinical data coded at the point of care becomes the source for claims data. Thus, as electronic health record system applications utilizing terminologies are implemented, healthcare providers need to systematically consider the effect on the coding function and management of the revenue cycle. A key factor is the sequence of events changes, i.e., instead of a health information management professional selecting billing codes at the conclusion of an encounter based on the review of the record, clinical data generates the claims data via mapping. Efficiencies and management challenges result.

MeSH terms

  • Economics, Hospital / organization & administration*
  • Forms and Records Control / economics*
  • Insurance, Health, Reimbursement*
  • Medical Records Systems, Computerized / economics*
  • Natural Language Processing
  • Systematized Nomenclature of Medicine