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Your Quick Key to Revenue Cycle Terms

If the oodles of revenue-related abbreviations are making your brain go haywire, keep this easy-to-read guide nearby to scan when memory fails you.


AR: Accounts receivable includes all the money that your facility is owed and hasn't been paid yet. Technically, that means reimbursement you expect from patients, minus several key factors: credit balances, bad debts, funding for conflict resolution, and applied (or unapplied) advance payments.


RTP: Return to provider refers to claims that aren't correctly billed, that contain errors, and that are on their way back to the provider for clarification of details - or simply denial.


RCM: Revenue cycle management means different things at different facilities, but can ultimately include all administrative and clinical work that establishes the capture, management and gathering of patient revenue.


ADR: Average daily revenue is determined by dividing three months' revenue by the number of days in those three months.


ROI: Return on investment refers to the degree of effectiveness with which your facility turns a profit. This phrase may, in health information management settings, also refer to "release of information."


OCE: Outpatient code editor is a system of edits that applies to hospital outpatient services. The system figures out whether specific codes earn separate payment under the outpatient prospective payment system (OPPS).


- Published on 2004-04-16