RHIT RHIA Exam Prep- Revenue Cycle
(Limited)- Complete Exam Study Guide
2026/2027 with Verified Answers | Newest
Version. A+
Patient Registration
the collection of patient data in order to register and start a patient record
revenue cycle management (RCM)
The process of managing the financial aspects of a healthcare
organization's patient encounters, from the scheduling of appointments to the final payment
collection.
RCM involves activities such as patient registration, coding and billing, claims submission,
payment
posting, and denial management
Coding
The process of assigning standardized codes to diagnoses, procedures, and services provided
during a patient encounter. Medical coders use coding systems such as ICD-10 (International
Classification of Diseases, 10th Edition) and CPT (Current Procedural Terminology) to accurately
represent the healthcare services delivered.
Claims Submission
The process of submittng claims to payers (e.g., insurance companies, Medicare,Medicaid) for
reimbursement of healthcare services provided to patients. Claims include detailed
information about the patient, diagnosis, procedures, and charges.
Payer
An entity responsible for reimbursing healthcare services, such as an insurance company,
government program (e.g., Medicare, Medicaid), or self-funded employer. Payers have their
own reimbursement policies and guidelines that healthcare organizations must follow.
Denial Management
, The process of identifying and addressing claim denials or rejections from payers.
Denial management involves analyzing and appealing denied claims to ensure proper
reimbursement and minimize revenue loss.
Biling
The process of generating and sending invoices or statements to patients or their responsible
parties for payment of healthcare services rendered. Billing includes detailing the charges,
deductibles,
copayments, and any outstanding balances.
Accounts Receivable(AR)
The amount of money owed to a healthcare organization for services rendered but not yet
collected. AR represents the outstanding payments from patients, insurers, or other responsible
parties.
Payment Posting
The process of recording and reconciling payments received from patients and payers.
Payment postng involves accurately applying payments to the appropriate patient accounts and
resolving any discrepancies.
Remittance Advice(Explanation of Benefits)
A document received from a payer that provides detailed
information about the reimbursement or denial of a claim. Remitance advice helps healthcare
organizations understand the payment amounts, adjustments, and reasons for denials.
Collection
The process of pursuing and collecting outstanding balances from patients or responsible
parties. Collection activities may involve sending reminders, making phone calls, negotiating
payment
plans, or engaging with collection agencies.
Key Performance Indicators(KPIs)
Metrics used to measure and monitor the financial performance of revenue cycle management.
Common RCM KPIs include days in accounts receivable (DAR), clean claim rate, denial rate, and
collection rate.
RHIT/RHIA Exam Prep- Revenue Cycle (Limited)
Patient Registration
(Limited)- Complete Exam Study Guide
2026/2027 with Verified Answers | Newest
Version. A+
Patient Registration
the collection of patient data in order to register and start a patient record
revenue cycle management (RCM)
The process of managing the financial aspects of a healthcare
organization's patient encounters, from the scheduling of appointments to the final payment
collection.
RCM involves activities such as patient registration, coding and billing, claims submission,
payment
posting, and denial management
Coding
The process of assigning standardized codes to diagnoses, procedures, and services provided
during a patient encounter. Medical coders use coding systems such as ICD-10 (International
Classification of Diseases, 10th Edition) and CPT (Current Procedural Terminology) to accurately
represent the healthcare services delivered.
Claims Submission
The process of submittng claims to payers (e.g., insurance companies, Medicare,Medicaid) for
reimbursement of healthcare services provided to patients. Claims include detailed
information about the patient, diagnosis, procedures, and charges.
Payer
An entity responsible for reimbursing healthcare services, such as an insurance company,
government program (e.g., Medicare, Medicaid), or self-funded employer. Payers have their
own reimbursement policies and guidelines that healthcare organizations must follow.
Denial Management
, The process of identifying and addressing claim denials or rejections from payers.
Denial management involves analyzing and appealing denied claims to ensure proper
reimbursement and minimize revenue loss.
Biling
The process of generating and sending invoices or statements to patients or their responsible
parties for payment of healthcare services rendered. Billing includes detailing the charges,
deductibles,
copayments, and any outstanding balances.
Accounts Receivable(AR)
The amount of money owed to a healthcare organization for services rendered but not yet
collected. AR represents the outstanding payments from patients, insurers, or other responsible
parties.
Payment Posting
The process of recording and reconciling payments received from patients and payers.
Payment postng involves accurately applying payments to the appropriate patient accounts and
resolving any discrepancies.
Remittance Advice(Explanation of Benefits)
A document received from a payer that provides detailed
information about the reimbursement or denial of a claim. Remitance advice helps healthcare
organizations understand the payment amounts, adjustments, and reasons for denials.
Collection
The process of pursuing and collecting outstanding balances from patients or responsible
parties. Collection activities may involve sending reminders, making phone calls, negotiating
payment
plans, or engaging with collection agencies.
Key Performance Indicators(KPIs)
Metrics used to measure and monitor the financial performance of revenue cycle management.
Common RCM KPIs include days in accounts receivable (DAR), clean claim rate, denial rate, and
collection rate.
RHIT/RHIA Exam Prep- Revenue Cycle (Limited)
Patient Registration
