Revenue cycle management is a vital part of any successful healthcare practice. It is a unique system that allows healthcare businesses to streamline their revenue, from the initial contact with the patient to final payments.

Revenue cycle management requires billing software, and healthcare practices usually employ third parties to develop or employ solutions for this process. Read on to learn what makes a successful revenue cycle and what you can do to achieve it.

The Steps of a Successful Revenue Cycle Management in Healthcare

When you employ a third-party agency to set up your revenue cycle, they usually work with you to learn more about your healthcare business. By doing this, they’ll know how to consult you and set up systems that will benefit your practice the most.

Here are the general steps of successful revenue cycle management:

Patient Registration and Pre-Authorization

Once a patient decides to reach out and schedule an appointment or make a profile on your online portal, you need to collect some personal information. That includes their health insurance and billing information.

These steps allow healthcare practices to check patients’ insurance status and confirm eligibility, and it helps them plan the way of receiving payments for provided services. To improve this step in the revenue cycle, most practices use automated verification tools to confirm their patient’s insurance eligibility.

Charge Capturing and Coding

Healthcare practices use universal medical codes that help tell insurance companies about the services they’ve provided to patients. So, after the patient receives a service, the provider needs to capture the charges and assign the correct billing code so that they can receive a reimbursement from the insurance company.

Well-designed medical billing software can automatically capture charges and assign appropriate codes. That helps minimize the chances of coding errors and saves thousands of dollars on resubmitting claims.

Submitting Claims

Once the codes are assigned, it is time to submit the claims to the insurance company. A successful revenue cycle management always double-checks everything before the submission, as this step can potentially save you a lot of money.
Many healthcare practices outsource their revenue cycle management and billing to providers dealing with this exclusively. That ensures that all the submitted information is correct and speeds up the reimbursement process.

Receiving Payment

After the insurance company reviews the claim, they reimburse the practice for provided services. Sometimes, they don’t pay the full amount, and it’s up to the provider to inform the patient about the amount they need to pay separately.

Analyzing the Revenue Cycle

One of the most important parts of any revenue cycle is the final analysis. You need to look at the whole process and improve any parts that create friction. Discover the most usual cases of denied claims, late payments, and other issues slowing down the cycle. Do that, and you’ll be able to receive compensation quickly and boost your profits.

What Is a Good Revenue Cycle Management Agency?

Peregrine Healthcare provides services that streamline your whole revenue cycle, freeing up your time and increasing your profits. Our solution can help you reduce costs, receive payments faster, and improve the satisfaction of your clients. Click here to learn more about our revenue cycle management services.