What Is Revenue Cycle Management?

For the healthcare industry, a revenue cycle entails the process of generating revenue, making payments, and processing claims. The revenue cycle management is well rounded software designed to effectively manage the medical billing process of the healthcare practice. It efficiently tracks billings, payments, and claims. It also takes care of the more sophisticated tasks of patient eligibility determination, keeping a follow up on denied claims, claim coding, and collecting individual, and copayments.

A proper revenue cycle management system can help save a physician from almost a 10% loss in revenue simply by keeping track of claims submitted to the CMS, following up on the ones rejected, and re-submitting ones that can be submitted again – hence, increasing the payments received, and decreasing the amounts written off as bad debts.

How can it Help Your Practice

Keeping track of patients’ medical billing and payments can be a tedious job. This is where a revenue cycle management can prove its worth for your business. It helps you overcome the following problems in the system.

Poorly trained staff

It helps you eliminate the adverse effects that an untrained member of the staff can have on the overall process. Each process in the revenue cycle has a chain effect on the other. So if one person is not doing their job properly, or does not know how his job affects the other processes in the cycle, the entire cycle suffers. It results in costly errors that can be avoided by automating the entire process.

Little or no communication between members of the staff

For a business practice to perform well it is imperative that different departments coordinate and communicate with each other. Unfortunately, the healthcare industry sees a serious lack of communication between physicians and the finance department, which hinders the smooth flow of systems. Automating the revenue cycle means the finance department does not need an appointment to get the financial reports, accounts receivables, revenue, and collections reviewed collectively. The system allows physicians to review transactions as and when they occur.

Errors and omissions

The manual system is prone to human mistakes. You may have had countless occasions where your staff forgot to check patient’s eligibility, or you missed to check for balance charges of an existing patient before drawing up the new bill. The revenue cycle system streamlines the procedure, and automatically picks up on patient data that helps you save time, costs, and even your practice.

If not properly dealt with, your revenue cycle can become an overwhelming process that conflicts with all the other activities in your practice. This calls for a dire need for your practice to become financially efficient. You need to take necessary steps to optimize the process of your revenue cycle.

A revenue cycle management program can help you achieve practice specific goals by streamlining this important function with other facets of your practice. All you need to do is to make sure that you partner with a revenue cycle management provider that helps you derive the most out of your revenue cycle.

Share this article

Saqib Ayaz is an expert in managed enterprise HR and technology outsourcing. He co-founded WorkflowOptimization.us

Facebook Comments