Revenue cycle management (RCM) can be defined as the process of handling claims, processing payment and generating revenue in the healthcare industry. It begins just at the time when a patient makes an appointment and continues until the balance on his account becomes zero. It includes various steps like checking patient insurance eligibility and coding claims
- RCM is responsible for all administrative tasks including informing patients of an upcoming appointment, reminding payers and patients of an existing balance and questioning insurers, when a claim is denied.
- It save providers money by reducing the amount of denied claims and enabling patients to pay their bills online.
- It allows healthcare staff to enter all the information required for claims processing, and avoids the revision or resubmission of claims.
- The organization can also check where its revenue cycle has the scope of improvement by arranging billing data and producing corresponding reports.
- With the help of RCM, an organization can buy analytics software and use dashboards to determine or analyze revenue goals
Benefits of Revenue Cycle Management (RCM)
- A well-designed RCM system tracks patient care simplifies the billing and collection cycles, by registering, appointing, scheduling and processing the payment.
- With the help of RCM, communicating with the EHR and accounting systems becomes easier.
- Revenue cycle management links administrative data like a patient’s name, insurance provider and other personal information along with the treatment received by a patient.
- It bridges the gap between the business and clinical sides of healthcare.
- Healthcare providers take help of revenue cycle management systems for preserving and managing patients’ billing records.
- It reduces the time between offering a service and receiving payment for it by interacting with other health IT systems like electronic health record systems and billing systems.
- It enables the RCM system to perform duties automatically. As this was previously handled by employees, RCM has been able to save healthcare practices time.
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