Vitality
A successful RCM process is essential for a healthcare sector to practice, to maintain financial viability and continue to provide quality care for their patients.
Revenue Cycle Management (RCM) is the process of identifying, collecting, and managing the practices revenue from payers mainly based on the services they provided.
The revenue cycle comments from when the patient makes appointment and ends with successfully complete payment collection. The revenue cycle is defined in such a way that all administrative and clinical functions that contribute to capture, management and collection of patient service revenue. This cycle describes the lifecycle of a patient in healthcare from admission to final payment.
This is the financial process which utilize medical billing software that healthcare sector uses to track patients from registration and appointment scheduling to final payment of bill. This unifies the business and clinical side of healthcare by integrating administrative data like patients name, insurance provider, personal information of patients with that treatment patient receives and with their healthcare data.
Health insurance companies is a key component of RCM.This is when patient schedules for appointment with physicians and before visiting physician’s office or visiting hospital, the hospital staff check the patients reported insurance coverage.
Revenue cycle factors involves charge capture, claim submission, coding, patients collections, Preregistration, registration, remittance processing, Third party follow-up, Utilization review.
In the RCM systems healthcare sector providers purchase and deploy designated RCM systems to store and manage patients billing records.
RCM system helps in reducing the amount of time between providing a service to the patients and receiving payment by interacting with other health IT systems- Electronic health record and medical billing systems .RCM systems save healthcare organizations time by automating duties that were previously handled by staffs. This include administrative tasks of informing reminding patients of upcoming appointments, reminding payers and patients of an existing balance and reaching out to insurers with specific questions when a claim is denied. The existing systems mention why claims been denied.