What is Healthcare Revenue Cycle Management?

Revenue cycle management is sometimes called RCM. It refers to a financial process using healthcare specialist billing software. Medical organizations use RCM to track patient care episodes. They track their patients’ care from preregistration to payment of the final balance.

RCM unifies both the business and clinical sides of the healthcare industry. It matches up the patient’s administrative details with the treatment that he or she has received.

Healthcare RCM involves all the administrative and clinical functions that relate to patient revenue. Management of it will include:

  • Capturing all charges.
  • Submitting insurance claims.
  • Using the right codes for diagnoses and medical procedures.
  • Estimating the correct balance for patient payments.
  • Collecting payment from patients.
  • Collecting patient information.
  • Processing of remittances.
  • Carrying out follow-ups on all third-party payments.
  • Collection of insurance payments.

There are several factors that affect healthcare revenue cycle management. These include:

  • The fees charged for services.
  • The volume of patients.
  • The productivity of the provider.
  • Insurance claim reviews.
  • Patient payments.

A number of healthcare providers now use healthcare revenue cycle management systems. These systems store and manage patient invoices and payment records. As a result, there is a reduction in the time between treatment and payment. This allows the provider to collect more revenue in a timely manner.

A healthcare receivables management system can save healthcare providers time and money. By using automation, providers can improve their cash flow. The number of insurance claim denials also goes down. By putting a high-quality receivable cycle management system in place, healthcare organizations can reap the benefits.