In revenue cycle management, what does "claim submission" entail?

Claim submission is a critical step in revenue cycle management, as it involves the process of sending coded information and billing requests to payers for reimbursement. This process ensures that healthcare providers receive payment for the services delivered to patients. During claim submission, healthcare professionals use various coding systems, such as ICD, CPT, and HCPCS, to accurately represent diagnoses, procedures, and services provided during patient encounters. The completed claim is then submitted to insurance companies or government payers for processing and payment.

The successful submission of claims is essential for the financial health of healthcare organizations, and it requires accuracy and attention to detail. Errors in coding or documentation can lead to claim denials or delayed payments, which can significantly impact revenue flow.

The other choices represent important aspects of revenue cycle management but do not specifically define claim submission. Providing a summary of services rendered is relevant for patient communication and billing but is not the act of submitting a claim. A review of patient accounts for accuracy is crucial for ensuring that the submitted claims are correct but occurs before the claim submission. Generating financial reports is essential for assessing the overall performance of the revenue cycle but is unrelated to the specific task of submitting claims for reimbursement.