Guide to Streamlining the Clinical Revenue Cycle

Original content provided by BDO USA


Efficient revenue cycle processes play a critical role in securing the financial stability and sustainability of healthcare organizations. These processes help support complete and accurate charging, coding, billing, and reimbursement while maintaining compliance with regulatory requirements. However, traditional approaches often separate Health Information Management (HIM), Clinical Documentation Integrity (CDI), and Coding into disconnected silos, leading to compromised outcomes, inefficiencies, communication gaps, and missed opportunities for clinical collaboration.

By integrating HIM, CDI, and Coding – along with Revenue Integrity - into a cohesive Clinical Revenue Cycle function, organizations can unlock significant benefits. This alignment promotes seamless coordination, enhances documentation accuracy, and improves charge and code capture, while reducing denials, promoting effective and efficient physician collaboration, and improving overall operational efficiency. Furthermore, it enables organizations to leverage the expertise of each department, leading to improvements in reimbursement and performance in quality/value-based contracts, reduced compliance risks, and enhanced patient care.

This white paper aims to provide a comprehensive understanding of the advantages and best practices for creating a Clinical Revenue Cycle framework, focusing primarily on HIM, Coding, and CDI integration. It explores governance and compliance considerations, offering insights into industry guidelines and best practices. Foundationally, the framework emphasizes the importance of accurate and comprehensive documentation, which has positive impacts on quality measures, performance indicators, value-based care, and overall reimbursement. By embracing this integrated approach, organizations can optimize their revenue cycle structure, drive sustainable financial success, and deliver high-quality care to patients.

Download the white paper today to learn how to streamline the clinical revenue cycle to enhance revenue performance, improve compliance, and ultimately achieve better financial outcomes while maintaining a focus on delivering exceptional patient care.