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UR specialists should understand these parts of the revenue cycle
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| While understanding the entire revenue cycle process is not a core requirement for UR specialists, understanding how hospitals and physicians get paid and what their patients are financially responsible for will allow the UR specialist to provide services that are more patient-centered and optimized in value to the organization.
In particular, this book will help UR understand the following essential revenue cycle topics:
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Key intersections of revenue cycle functions and major UR areas -
When and why to self-deny and rebill -
The nuances of transfer payments -
Occurrence codes, condition codes, and modifiers relevant to the UR process -
The impact of value-based payment models and bundled payments on hospital billing and services
For UR-specific guidance on each of these topics and more, order The Hospital Guide to Contemporary Utilization Review, Second Edition.
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