CHAA Revenue Cycle Management Flashcards
6 cards from real CHAA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 CHAA Revenue Cycle Management flashcards as text
Which phase of the revenue cycle begins when a patient schedules an appointment?
Answer: Pre-encounter
The pre-encounter phase starts when a patient first contacts the facility, including scheduling. This phase involves gathering demographic and insurance information before the patient arrives. Proper handling at this stage reduces downstream billing errors.
What is the primary purpose of charge capture in the revenue cycle?
Answer: To record all billable services provided to a patient
Charge capture is the process of recording all services, procedures, and supplies provided to a patient so they can be billed accurately. Missing charges lead to revenue leakage. This step bridges clinical documentation and billing.
What does 'clean claim' mean in healthcare billing?
Answer: A claim submitted without any errors or missing information
A clean claim is one that contains all required information, is free of errors, and can be processed without additional information from the provider. Clean claims result in faster reimbursement. The industry benchmark for clean claim rates is typically above 95%.
Which department typically handles denied claims in the revenue cycle?
Answer: Patient financial services or billing
Patient financial services or the billing department is responsible for managing denied claims, including investigating the reason for denial and submitting appeals. They work to recover revenue that would otherwise be lost. Effective denial management is critical to financial performance.
What is the typical order of revenue cycle steps?
Answer: Scheduling, registration, charge capture, claims submission, payment posting, collections
The revenue cycle follows a logical flow from patient scheduling through registration, service delivery with charge capture, claims submission to payers, payment posting when reimbursement is received, and finally collections for outstanding balances. Each step builds on the previous one.
What is revenue leakage in healthcare?
Answer: When revenue is lost due to missed charges, coding errors, or inefficient processes
Revenue leakage occurs when a healthcare organization fails to capture all revenue it is entitled to, often due to missed charges, undercoding, billing errors, or untimely filing. Studies suggest hospitals lose 1-5% of net revenue to leakage. Identifying and addressing leakage points is a key revenue cycle function.