Healthcare Revenue Cycle

If you’re wondering what healthcare revenue cycle management is, it’s a term that refers to the process of keeping a healthcare organization’s finances in good shape. From billing and collections to coding and provider enrollment, RCM covers a patient’s full financial path in healthcare.

The collecting, processing, and management of patient billing information can be made more efficient and accurate by implementing technology such as revenue cycle management solutions. In this article, we will discuss what healthcare revenue cycle management is and how it can help you. 

What is Revenue cycle management?

It is a method used by healthcare organizations to track revenue from patients from the time they make their first appointment or encounter with the organization until they settle their amount.

Preregistration, registration, charge capture, claim filing, remittance processing, insurance follow-up, and patient collections are the seven steps of the revenue cycle. 

The purpose of revenue cycle management is to identify and eliminate any sources of friction in a provider’s revenue cycle. Care providers can maximize claim settlements and improve income with efficient revenue cycle management.

Benefits of Healthcare revenue cycle management

RCM’s primary purpose is to enhance provider revenue, but it also provides additional benefits in the process. These advantages benefit both providers and patients, making revenue cycle management even more valuable.

Let’s look at a few of the benefits of revenue cycle management.

Identifying and Resolving Errors.

Healthcare providers can more quickly identify where errors occur in the revenue cycle by utilizing RCM. Because nearly 90% of claim denials are attributable to easily preventable technical errors, such as missing information in the patient’s chart or inaccurate coding, this reduces the chance of claim denials. 

Decreasing Administrative Burden 

Keeping claim denials to a minimum reduces the administrative load. More time and energy are freed up for patient treatment when administrative staff members do not have to spend time and energy verifying and challenging refused claims.

Avoiding Healthcare Fraud 

RCM prevents healthcare fraud and abuse. Every year, healthcare fraud costs the industry billions of dollars. A fraud investigation can cost a provider both money and their reputation.

Incorrect medical coding, whether deliberate or unintentional, can lead to healthcare fraud investigations.

With the priority on correct data collection, invoicing, and coding in revenue cycle management, providers are far less likely to send faulty information to insurance companies. RCM can also keep practitioners up to date on ever-changing healthcare legislation, ensuring that unintended fraud is never an issue.

Increasing Healthcare Facility Revenue

Healthcare providers can receive compensation for their services quickly by minimizing technical problems, claim denials, and fraud investigations. They can also save thousands of dollars by not having to deal with errors, dispute claims, or investigate fraud.

Providers will be able to invest more in their patient’s treatment as a result of their increased revenue. After all, providing high-quality patient care is a major priority for any healthcare professional.

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