Revenue cycle management (RCM) is a financial process that is used by healthcare providers to bill, track and collect incoming payments. RCM encompasses patient registration, insurance verification, claims submissions, patient billing and collections. The RCM market is projected to exceed US$238 billion by 2030.
Below, we'll cover what the RCM process entails, how to simplify the process and address common challenges, and best practices for improving financial outcomes.
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Components and stages of the healthcare revenue cycle
Healthcare businesses rely on RCM to achieve financial stability, efficiency and better patient care.
Financial stability: RCM promotes a steady flow of income for healthcare providers by capturing and collecting payment promptly for the services rendered.
Efficiency and reduced costs: The RCM process saves time and resources spent on administrative tasks, such as billing and coding, allowing staff to focus on patient care.
Improved patient experience: A well-managed RCM system facilitates accurate billing and easier payment processes, minimising confusion and improving the overall patient experience.
How revenue cycle management benefits healthcare operations
The healthcare revenue cycle has several stages which ensure that healthcare providers are compensated for the services that they deliver.
Pre-registration: Collecting a patient's demographic and insurance information before their visit.
Patient registration: Collecting further patient information, such as personal details and medical history.
Insurance verification and authorisation: Checking the insurance cover and obtaining the necessary authorisations for procedures.
