Surgeon’s Role in the Revenue Cycle: A Blueprint for Young Surgeons

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Amy Boyer, MBA

Surgeon’s Role in the Revenue Cycle: A Blueprint for Young Surgeons
Healio ⋅ Orthopedics Today – August 2017

by Amy Boyer, MBA

Whether a physician’s compensation is tied directly to productivity or collections, or is indirectly influenced by the overall financial sustainability of the practice or the hospital, the physician’s paycheck depends on the employer getting paid for the patients who are treated. Surgeons new in practice often do not understand the interrelated aspects of how the practice bills and collects for these services. This article explains how the revenue cycle works and the key areas that require physician involvement. A glossary of common revenue cycle terms is included.

Revenue cycle

In short, the revenue cycle consists of all the steps required to get the surgeon paid. The diagram herein illustrates these steps.

There are many parties involved in the revenue cycle, not just the billing department. Everyone in the practice has a role to play, including the surgeon. Without collecting the right information prior to a patient appointment, front desk staff will not know whether patients are eligible for coverage or how much to collect. Without the right documentation details, staff cannot accurately bill for the surgeon’s work. And, if the surgeon tells the patient, “Do not worry about the bill,” well, then it has just become harder for the team to collect.

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