Revenue cycle management (RCM) refers to the financial flow of practice/ provider. It also make sure error free billing process. RCM manage all processes - starting from booking an appointment to payment of remaining balance generating cash flow for healthcare organizations. It also develop trust of patients with practice/ provider that they have full value of treatment.
Five Components Of RCM:
1. Registration And Appointment Scheduling:
Healthcare facility collect patient's demographic data rand insurance information related to insurance taken by the patient and asses eligibility for treatment as per insurance cover, when patient books an appointment.
2. Insurance Verification:
To avoid any disputes in the future with insurance company, it is very critical to verify insurance information of a patient.
3. Claim Submission And Charge Capture:
After providing needed treatment to a patient, practice/ provider send all relevant information regarding the treatment/ service provided, to insurance companies for reimbursement.
4. Payment Posting And Claim Management:
Payment posting, claim denial management, statement processing, and other follow-ups with insurance companies are performed by back end staff.
5. Patient Collections:
In this process balances from patients are collected.
Importance Of Revenue Cycle Management:
1. Revenue Generation:
Seamless operation for any healthcare facility require perfect cash flow and only perfect RCM can generate smooth cash flow.
2. Patient Verification:
At time of patient appointment, revenue cycle management perform insurance verification of a patient, and and also other information of a patient. RCM ensures that no data is left unchecked.
3. Cost Determination:
RCM accurately determine costs of service including treatment which is to be provided to the patient reducing chances of error which might occur in the manual calculation of such costs.
4. Cash flow management:
RCM helps in managing healthcare facility’s cash flow. Effective cash flow management is necessary for seamless operation of any healthcare facility.
5. Smooth collection process:
RCM collect payments from insurance companies and patients, with systematic cycle in place, and therefore it also avoid any unforeseen uncertainty.
6. Enhanced patient experience:
Main objective of a healthcare facility is to provide continuous support to patients through their services. RCM helps healthcare facility to provide improved experience as physicians are free to focus on patient care.
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