What is the Healthcare Revenue Cycle? - Part 4

[@yonatanpistiner1607]

Question: once the claim is accepted and the adjudication process starts, does it mean the provider 100% will be reimbursed, payed as needed? or there are cases after the initial approval of the claim that it will be rejected or partially approved by the insurance company? Thx!

[@riyaspp3169]

Really helpful 👌

[@InleraU]

Yay!! 🤗 so happy to hear that you found it helpful!

[@micahgriggs1761]

Would clinical documentation fall under "diagnosis & charge capture" or "charge review & scrubbing"?

[@InleraU]

Depending on the practice's process flow, it most likely would fall somewhere between the patient visit & the charge capture. The provider and/or scribe is responsible for completing the clinical documentation. The charge capture follows the documentation as the procedures are captured from the finalized documenation.