Revenue Cycle Management of any healthcare organization is the backbone of all the processes it runs. Revenue Cycle Management is the administration of all the financial operations related to medical billing. It ensures that the provider makes timely payments for the smooth running of billing processes.
Healthcare Revenue Cycle Management companies mostly use billing software to facilitate patient care from the time of patient registration until the final reimbursement of the services provided to the patient.
There are several Healthcare Revenue Cycle Management Companies offering their services to numerous hospitals, clinics, and nursing homes. We will take a look at the steps followed by these companies for the efficient management of the Revenue Cycle.
- Using RCM software:
The first step in the revenue cycle management is the use of RCM software. This software facilitates the Healthcare Revenue cycle management companies in the input and processing of necessary data.
- Scheduling patients:
The next step is scheduling and preauthorization of patients. Scheduling helps in the administration of patients and helps avoid long queues. Long queues and unscheduled patients can jeopardize the business. This would provide only limited care to few patients hence affecting the revenue cycle.
- Checking the patient’s eligibility:
After proper scheduling of patients, the next step is to check if a particular patient is eligible for the process. The qualification includes factors such as whether the patient is covered by insurance, and if the information provided is accurate. Most of the revenue cycle management companies use RCM software to check the eligibility of patients.
- Submitting Claims:
For the payers to make the payment, it is necessary to file claims. Claims include the services provided to the eligible patients and the amount to be paid by the insurance companies. To avoid human errors in claim submission, RCM companies use Practice Management (PM) software to submit claims automatically.
- Collecting payments:
When the claim is submitted, and it is reviewed by the RCM Company, the refund is posted. The payer needs to make the reimbursement now as the next step. RCM software helps in the quick payment by the payer as well by making it more feasible for them to review and approve claims.
- Managing denied claims:
Sometimes the claims generated are rejected by the payers for several reasons. Some of these reasons are ineligibility of patient or the errors in billing and coding. The RCM companies look for these reasons and resolve these problems for lesser denials next time.
- Reporting:
Reporting is an important step to see if the RCM company is meeting the goals or not. The reports exhibit financial performance and key data to see if the company is achieving the benchmark.
There are some Revenue Cycle Management Companies that can help you improve your revenue cycle significantly.
