Healthcare Revenue Cycle Management is the end to end spectrum of administrative and clinical functions that lead to the capturing, management and collection of patient service revenue. This covers the patient account from its initiation to payment.
Here are the key features of the Cycle Healthcare:
- Starts with the patient making an appointment and ends only after the balance on his/her account is zero.
- Identifies all opportunities that may affect positively or negatively the ability of the practice to collect.
- Assists on the basis of the opportunities to figure out the maximum revenue that can be collected.
- Minimises costs associated with the payment methods; smart services are provided.
- Cycle Healthcare takes the billing out of being just a back office function and attaches it to the aspect of prevention.
- Translates to on ground, real time actions such as:
- On appointment scheduling, expected payment must be clearly stated and previous balances cleared.
- On patient check in, the money must be collected, eligibility of the patient checked
- All documentation and notices must be signed and coded at the clinician’s desk.
Cycle Healthcare does not simply operate like a billing desk. It is strategic in its administrative functions. It is a preventive plan for better management. And loops every member in the practice to ensure better revenue and services.
A system of feedback comes with it and clinics and back offices function in sync with each other.
This is in recognition of the fact that when documentation for services is not complete or specific, time and money are wasted, as claims either need additional research before filing or are rejected and must be re-filed.
Thus, Revenue cycle management brings together the economic business and medically clinical sides of healthcare by placing beside each other administrative data such as a patient’s name, insurance provider and other relevant personal information and the treatment a patient receives. Healthcare providers usually put in place revenue cycle management systems. These interact with other health IT systems, cut down the time and hassle and make the process of providing health services, claiming insurance and settling claims and receiving payment in time smoother. It also automatically performs duties that were earlier employee dependent.
Automated corresponding reports generated by these systems and softwares help heath care practices improve their strategies. Often, the Revenue Cycle Management is outsourced to companies with expertise in this area as key vendors in the sector sell both stand alone products or RCM systems integrated with EHR systems. For a list of the top 100 EHRs checkout this article on Medical Economics©.
Altogether, the Cycle Healthcare makes sure that the practice remains sustainable, relevant and well managed throughout.