Revenue management is extremely crucial for all types of business to make sure that the incoming cash is enough to make the payment of the expenditures. Healthcare sectors always give priority to the healthcare of the patients and also safeguard their lives. The revenue cycle management solutions take care of the processing of the claims, reimbursements from insurance providers, and several other essential factors for the smooth delivery of healthcare. The RCM process is a multipurpose method that manages the patient accounts in detail without any hassle. The goal is to develop a process that will help the organizations to get paid the full amount for services as soon as possible.
Revenue cycle steps
It is a multi-step process that results in smooth payments. Here are the steps of the method:
● Verification: The RCM gathers and syncs all the information related to the patient and the administrative staff like insurance verification forms, patient intake forms, etc. Just after a patient has made an appointment, the management makes sure that all the steps are completed accurately.
● Charge capturing: This is the second process where the health experts or care providers transcribe all their services into billable charges. In order to determine the reimbursement amounts, every service offers a universally accepted medical code.
● Claim submission: The RCM makes sure that there is no error in coding or else it can get denied. Now the claim is sent to the insurance company for approval. With the help of the revenue cycle management solutions, the submission happens quickly and the process becomes easier.
● Payment collection: After the claim of the patient has been approved, the provider is reimbursed by the insurance company depending on the eligibility of the patient. All these steps help in collecting the final payment without any delay.
● Medical service review: The provider thoroughly reviews the clinical treatment data so that there is no chance of error. At the same time, it increases the revenue of the providers, enhancing the patient experience.
What are the benefits?
- Relying on a trusted RCM helps the administration decrease its burden. They need not spend time on investigation and they can utilize the time for patient care.
- The chances of healthcare fraud become minimized with the help of RCMs. The upcoding process offers a higher reimbursement rate and accurate data collection.
- The process is straightforward and secure which reduces the hassle of physicians, coding specialists, and administration.
Healthcare revenue cycle management solutions are becoming popular with the passing days. Health professionals need their help to be aware of their revenue cycle so that they can provide appropriate service and get proper reimbursement. Healthcare organizations can’t manage the complete bill payments without the help of this key financial process. There are too many RCMs available in the industry, but choose one who has a long experience in this field with a good reputation. This was all about the role of revenue cycle management in the healthcare sector.