Revenue cycle management (RCM) is the financial process that healthcare facilities use to track patient care episodes from registration and appointment scheduling to the final payment of a balance.
The efficiency of a medical practice’s billing operations has a critical impact on financial performance. Determining the ultimate gatekeepers of the billing function – whether an in house team or a third party company – is one of your most important decisions.
Problems with the Healthcare Revenue Cycle:
Beyond just tracking a claim, your revenue cycle encompasses all the many steps from when a patient first makes an appointment to the time when there is no longer a balance on that person’s account. It includes front-end office tasks like appointment scheduling and insurance eligibility verification; tasks related to clinical care like coding and charge capture; and back office tasks like claims submission, payment posting, statement processing and the management of denied claims.
Healthcare professionals look to the latest RCM platforms to help them process patients efficiently while satisfying new regulations. We compare choices in this critical category. Choosing the right revenue cycle management (RCM) system can make or break a hospital or physician practice.
The health care revenue cycle is just beginning to feel the effects of consumerism as employers focus on containing health care costs. This means that today’s growing financial pressures on health care organizations will continue to increase as consumers bear an increased financial responsibility for their health care costs. Revenue cycle solutions that extend the capabilities of your hospital information systems are the key to improving access management, responding to health care consumerism, accelerating cash collection and improving payor performance.
As the healthcare industry continues to change, the complexities of medical billing are increasing even as reimbursements are decreasing. Healthcare professionals are simply working harder to get paid less. Your practice needs a strong RCM team with a preventive mindset.
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