What is Healthcare Revenue Cycle Management

What is Healthcare Revenue Cycle Management

Healthcare is a relatively complex industry that uses several systems to make operations smoother. One of those systems is the revenue cycle, and it covers everything from the registration of a patient to their final payments.

Revenue cycle management uses medical billing software, and it is the bridge between the clinical and business sides of a healthcare practice. Read on to learn all about it.

What Is Revenue Cycle Management in Healthcare?

Revenue cycle management is a strategy used by healthcare entities to manage their revenue. It encompasses all the steps from the initial contact with the patient, until they settle all their medical bills. 

Usually, healthcare offices employ a third party to help them with revenue cycle management. These consultants can assist them in setting up suitable systems and explaining the best way to track their revenue. The goal is to identify and eliminate any friction points and increase profits.

What Are the Steps in the Healthcare Revenue Cycle?

The revenue cycle consists of several steps, so let’s go over the basic ones to understand better what we are talking about:

  • Eligibility verification.

When a patient reaches out, a healthcare provider creates a user account with their personal information. The most important step of this process is collecting insurance information and verifying the eligibility. 

  • Coding and charge capturing.

Medical practices use universal codes to transcribe patient services into billable payments. These are vital for later reimbursements by insurance companies, which is why charge capturing and coding must be done with perfect accuracy.

  • Claims submission.

After the performed services have been transcribed into medical codes, it is time to send them to an insurance company for approval. 

  • Payment collections.

Once the claim is accepted, the insurance company reimburses the healthcare provider based on eligibility. If there are any outstanding balances afterward, the provider must reach out to the patient to settle them.

  • Analyzing the cycle.

A big part of RCM is analyzing data and finding inefficient steps in the cycle. Correcting errors and adjusting practices is vital to increase your revenue.

The Benefits of Healthcare Revenue Cycle Management

Proper revenue cycle management allows efficiency, accuracy, and minimizing the chances of delayed or lost revenue. The most common benefits include:

  • Avoiding technical errors
  • More accurate medical coding
  • Decreasing administrative burden
  • Fever healthcare fraud incidents
  • Improving efficiency
  • Increasing revenue

RCM is a vital tool for healthcare providers to minimize the chances of errors in a revenue cycle and improve profits. It automatizes the whole process, which decreases the time needed for the administrative functions. That opens the possibility to better treatment and focus on patient care.

Who Can Help Me With Revenue Cycle Management?

At Peregrine Healthcare, we focus on improving your revenue cycle, streamlining the whole process, and boosting profits. We set up systems that reduce costs, save you time, and improve your patients’ satisfaction. 

We offer an effective collection system, patient support, maximum reimbursement, and detailed reporting. Click here to learn more.


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