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    Revenue Cycle Management: Don’t Get Lost in The Financial Maze

    Kem Tolliver, FACMPE, CPC, CMOM
    Shawntea “Taya” Gordon, MBA, FACMPE, CMOM

    Book

    ISBN: 978-1-56829-677-7

    SKU: 1008

    Non-Member Price$129.00

    Member Price$99.00

    eBook

    ISBN: 978-1-56829-678-4

    SKU: E1008

    Non-Member Price$109.00

    Member Price$63.20

    Package

    SKU: PK1008

    Non-Member Price$139.00

    Member Price$109.00

    Formats:

    Book
    Non-Member Price:

    $129.00

    Member Price:

    $99.00

    eBook
    Non-Member Price:

    $109.00

    Member Price:

    $63.20

    Package
    Non-Member Price:

    $139.00

    Member Price:

    $109.00


    Description

    How does the revenue cycle of a medical practice actually work? It is easy to get lost in all the phases of revenue management, so how does a practice keep it all straight? Proven solutions to optimize revenue cycle are the key, and this primer is a business-critical resource to deliver just that. Whether you’re new to managing the revenue cycle or a seasoned professional, the concepts covered in these pages are key to your success. 
     


    Table of Contents

    TABLE OF CONTENTS

    Dedication

    Acknowledgments 

    Preface

    Chapter 1: Defining the Revenue Cycle Model (RCM)

    Chapter 2: Practice Preparation: Are You Planning to Fail?

    Chapter 3: Scheduling & Pre-registration

    Chapter 4: Eligibility, Referrals, & Authorizations

    Chapter 5: Appointment Confirmations

    Chapter 6: Check-In & Time-of-Service Collections

    Chapter 7: Documentation & Coding Background

    Chapter 8: Charge Entry

    Chapter 9: Claims Preparation & Submission

    Chapter 10: Deposit Management & Internal Controls 

    Chapter 11: Payment Posting

    Chapter 12: Denial Management

    Chapter 13: Insurance A/R Follow-Up

    Chapter 14: Patient A/R & Follow Up

    Chapter 15: Reporting

    Chapter 16: Compliance & Risk Management

    Chapter 17: Conducting an Internal Revenue Cycle Assessment

    Chapter 18: Change Management

    Appendices

    Glossary

    Index

    About the Authors
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    Please contact the MGMA Service Center toll-free at 877.ASK.MGMA (877-275-6462) for issues or concerns with this book.


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    Kem Tolliver

    Written By

    Kem Tolliver, FACMPE, CPC, CMOM

    Kem Tolliver a public speaker, co-host of the RevDive podcast and co-author of Revenue Cycle Management: Don't Get Lost in the Financial Maze. Medical practices managed by Kem have received MGMA Better Performer distinctions in the areas of A/R and collections. 

    As president of Medical Revenue Cycle Specialists, LLC, she and her team lead healthcare organizations in practice startup and transformation, revenue cycle improvements, clinical documentation improvement, educational programming, payer contracting, HIT software development, EHR/PM software customization, risk management and telehealth integration. 

    With a desire to impact public health, she offers strategies to CINs, ACOs and MCOs on interoperability, clinical workflow redesign and transitional care management. She has bachelor of science degrees in healthcare administration and organization management, with summa cum laude and magna cum laude distinctions, from Washington Adventist University.

    Maintaining board certifications from AAPC, MGMA and PMI allows Kem to be an industry thought leader who is called upon to provide strategic guidance on regulatory and operational improvement outcomes. She has served on the Board of Directors at Laurel Regional Hospital, as well as on the Board of Directors of Maryland MGMA as the chair of the Government Affairs Committee and the State of Maryland’s ACMPE Certification Rep. Kem is the President of the PG County Chapter of AAPC.          

    Shawntea “Taya” Gordon

    Written By

    Shawntea “Taya” Gordon, MBA, FACMPE, CMOM

    Shawntea “Taya” Gordon, CMPE, CMOM, has a BS in healthcare management from Bellevue University, where she graduated summa cum laude. She is a subject matter expert (SME) in healthcare compliance, organizational governance, process optimization and revenue cycle management. She has held senior level executive management positions in private practices, collaborative institutes and national care coordination organizations. Moheiser consults on all areas of healthcare operations including performance improvement, quality improvement, risk reduction and the shift to value-based payment methodologies. She is on MGMA’s Government Affairs Council and recently co-authored Revenue Cycle Management: Don’t Get Lost in the Financial Maze with Kem Tolliver. Moheiser's thoughts on the innovative use of people and IT was included in the HIMSS Voices of Innovation Publication in 2019, coordinated by the Cleveland Clinic. She is also a 2019 Midland’s Business Journal “40 Under 40” Executives & Entrepreneurs Award recipient. Moheiser is the current president-elect for Nebraska HIMSS and currently sits on two workgroups with MGMA that provide feedback to CMS on proposed legislation. In addition, she is a speaker for state and national MGMA meetings, as well as several rural health associations. She has a passion for physician advocacy, engaging in several terms on government affairs and legislative committees lobbying for healthcare improvement.


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