Date
6-19-2024
Department
Graduate School of Business
Degree
Doctor of Business Administration (DBA)
Chair
Katherine Hyatt
Keywords
revenue cycle management, insurance denial management, data analytics, biller, coder, revenue integrity
Disciplines
Business
Recommended Citation
Scalf, Mary, "Revenue Cycle Management" (2024). Doctoral Dissertations and Projects. 5723.
https://digitalcommons.liberty.edu/doctoral/5723
Abstract
The healthcare industry continues to navigate through legislative changes requiring a change from the fee-for-service model to a value-based model. Healthcare is required to balance quality care of the patient and financial viability. The general problem to be addressed is the inefficient adoption of a revenue integrity program within the revenue cycle management process resulting in a revenue deficit for healthcare providers. The purpose of this qualitative case study was to add to the body of knowledge exploring the possible inefficient insurance denial management process within non-profit hospital-owned physician practices resulting in revenue deficits for the provider clinics. The study achieved this purpose by exploring barriers to the revenue cycle management process. The researcher conducted a qualitative case study with 14 participants. Based on the identified themes the researcher shared implications and strategies to improve general business practices. Additionally, this study shared recommendations for future research. To improve revenue cycle process healthcare organizations can consider improved communications, increase knowledge and skill set, focus on staff resources and retention efforts, review data analytics, and consider a revenue integrity adoption program.
