Healthcare Finance & Revenue Cycle

What problem does it solve?

This Skill simplifies the management of financial and revenue cycle processes in South African healthcare, streamlining billing, coding, and funding model management.

Core Features & Use Cases

• Healthcare Funding Landscape: Provides comprehensive information on South African healthcare funding models, including medical aid schemes, out-of-pocket payments, and public sector funding.
• Medical Aid Tariff Structures: Offers detailed insights into medical aid tariff structures, including NHRPL and NHCF, and their impact on billing and payments.
• ICD-10 Coding: Guides on ICD-10 coding, including diagnosis and procedure coding, ensuring accurate claims processing.
• DRGs: Explains Diagnosis-Related Groups (DRGs) and their role in hospital billing and payment.
• Revenue Cycle Management: Offers a step-by-step guide to revenue cycle management, from patient registration to collections.
• Denial Management: Provides strategies for handling claim denials and appeals.
• Financial KPIs: Offers key performance indicators for healthcare financial management.
• Public Sector Healthcare Finance: Delivers insights into public sector healthcare financing, including the MTEF and conditional grants.
• Use Case: For a healthcare finance director, this Skill can be a valuable resource for understanding and managing the complex financial aspects of healthcare operations in South Africa.

Quick Start

Use the Healthcare Finance & Revenue Cycle skill to get a detailed overview of South African healthcare funding models.