Follow a patient visit from scheduling to payment — registration, insurance verification, charge capture, coding, claims, adjudication, payment and denials.
The revenue cycle, step by step
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The revenue cycle is everything that happens to turn care into payment:
1. Scheduling & registration — demographics and insurance captured.
2. Eligibility & benefits verification — is the patient covered? Copay? Prior authorization needed?
3. Encounter — the provider sees the patient and documents.
4. Charge capture — services performed are recorded.
5. Coding — documentation becomes codes.
6. Claim submission — usually electronically through a clearinghouse.
7. Adjudication — the payer reviews and decides.
8. Payment posting — payments and adjustments recorded.
9. Denial management & appeals — fix and resubmit.
10. Patient statements & collections — the patient's share.