The medical revenue cycle begins when a patient schedules an appointment and ends when payment of their balance is final. The entire process is critical to ensuring accurate and timely payment to providers.
RCM also promotes patient satisfaction since it helps prevent the frustration of claim denials and drawn-out billing processes. Other benefits of RCM include:
- Reduction in claims denials.
- Improved collection rates.
- Increased overall revenue.
- Enhanced efficiency through system automation and redesigned workflows.
One of the primary goals of healthcare revenue cycle management is to reduce the number of accounts receivable (A/R) days. Accounts receivable can best be described as revenue that has been billed, but not yet paid.
For a health system’s financial well-being, it is important to have a steady stream of income. Too many A/R days can have a dramatic impact on its bottom line. Unfortunately, many healthcare providers and their staff simply don’t have the time or expertise to handle RCM internally, which can lead to:
- Decreased reimbursement due to improper coding, training, or workflows that slow down or stall your reimbursement.
- Increased claim denials due to poor workflows, improper use of data, or lack of timeliness.
- Payments stuck in A/R due to a lack of processes and patient engagement.
- Unoptimized workflows or limited capacity. Staff turnover due to frustration.