{"version":"0.38.0","built_at":"2026-10-24T19:53:00.313Z","license":"CC BY 4.0 © Mike Reams","canonical":"https://catalog.mikereams.com","value_stream":{"id":"VS-510","name":"Encounter-to-Cash","industries":["healthcare"],"description":"Turn care that was delivered and documented into payment: capture the charges, code the encounter, bill the payer, post what it pays, work denials, and bill and collect what the patient owes. Paying claims as a health plan is Claim-to-Payment.","outcome":"Each encounter is billed correctly once, paid at the contracted rate, and the patient's balance is resolved fairly.","trigger":"A clinical encounter or stay is documented and closed.","aliases":["Patient Revenue Flow","Patient Accounting Cycle","Charge-to-Cash","Charge-to-Payment"],"stages":[{"id":"VS-510.10","order":1,"name":"Capture Charges","description":"Capture every billable service from the record and reconcile charges against the work done.","capability_ids":["BC-1840.10"],"events":[]},{"id":"VS-510.20","order":2,"name":"Code","description":"Assign diagnosis and procedure codes from the documentation and query clinicians where it is unclear.","capability_ids":["BC-1840.20","BC-1820.10"],"events":[]},{"id":"VS-510.30","order":3,"name":"Bill the Payer","description":"Scrub and submit a clean claim to each payer in coordination-of-benefits order.","capability_ids":["BC-1840.30"],"events":[]},{"id":"VS-510.40","order":4,"name":"Post & Reconcile","description":"Post payments and adjustments from remittances and compare them with expected payment.","capability_ids":["BC-1840.30","BC-1840.40"],"events":[]},{"id":"VS-510.50","order":5,"name":"Work Denials","description":"Correct and resubmit or appeal denied claims and fix the cause upstream.","capability_ids":["BC-1840.40"],"events":[]},{"id":"VS-510.60","order":6,"name":"Bill & Collect from Patient","description":"Send the patient a clear statement, offer payment plans and assistance, and collect the balance.","capability_ids":["BC-1840.50","BC-1810.50"],"events":[]}]}}