Revenue Cycle Management (RCM) is a financial strategy healthcare providers use to manage financial and administrative functions. Revenue cycles start when the patient reaches out to the healthcare facility to make an appointment to when they pay for the appointment or treatment.
Healthcare RCM combines administrative data like insurance provider and patient demographic information, plus the healthcare they receive and their healthcare data. A good RCM can help healthcare providers shorten the reimbursement time by optimizing claim reimbursements and patient collections.
What Is Involved In a Revenue Cycle?
Pre-registration– Taking information like insurance coverage before the patient arrives for outpatient or inpatient care.
Registration– Collecting and verifying more information like phone number, address, insurance provider, and date of birth for creating a medical record.
Charge capture– Interpreting healthcare services into billable charges.
Claim submission- Submitting claims to insurance companies.
Medical coding– Using universal ICD-10 medical codes to interpret diagnoses and procedures.
Remittance– Explanations from the insurance provider showing the healthcare providers what they got paid for their services.
Patient collections– Determining balances from insurance reimbursement and collecting them from patients.
Benefits Of Healthcare RCM
Identifying and solving coding errors– Using strategic healthcare RCM solutions helps determine where mistakes mostly happen in the billing process, which helps reduce future denials.
Reducing the administrative burden– When administrative staff members are not working to deal with denials and billing errors, they have more time and energy to offer better patient care.
Avoiding healthcare fraud– RCM ensures accurate data and helps providers remain compliant with healthcare regulations.
Preventing patient fraud– Medical RCM helps avoid inaccurate patient information.
GeBBS Healthcare Solutions is a BPO company with world-class medical billing and coding professionals. Contact them today to get unmatched strategic healthcare RCM solutions to the rescue.
