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Why Revenue Cycle Management Is Important For Healthcare Industry

With a growing population, the subsequent rise in demand for healthcare facilities alongside claims to various medical reimbursements has rendered the medical bills profoundly blunder inclined.nnHealthcare providers are encountering a rise in the cost of operations and a reduction in revenues due to the changing government controls within the healthcare field. For this reason, revenue cycle management plays a crucial part in how organizations can work on a day-to-day premise.nnThough, healthcare organizations must have policies and practices in place for remaining financially fit.  Managing revenue is vital for the healthcare industry but it may not be the primary focus of healthcare providers. Every practice or healthcare organization recognizes the significance of RCM to some degree.nnHowever, organized and well-designed revenue management needs to be done to ensure proper and systematic revenue supplies, equipment, and salaries. It went without saying that a decrease in their financial stability can divert their concentration away from their core purpose.nnLet’s understand the importance of revenue cycle management.n

What Is Revenue Cycle Management?

nThe hospital revenue cycle stands so crucial because when it gets to the healthcare realm, it is not only the patient that the hospital should focus on but similarly financial side of the patients also requires equal consideration or attention. So, what exactly is RCM in medical billing?nnRevenue Cycle Management revolves around the patient collection issues and the efficiency of claim submission. Revenue cycle management starts when the patient enters a relationship with the healthcare organization.nnHe/she proceeds through the whole preparation until the treatment is done and any balance on the account is paid off. It incorporates dealing with claims, handling installments, and managing payments with disparities, with respect to insurance claims. In simple terms, it consists of the entire life of a patient account from creation to payment.nnRevenue cycle management (RCM) is evaluated as the revenue driver of healthcare. It includes the process that will take the hospital events and turn them into dollars for the organization or health system. While there are different variations between the healthcare provider and payer types and how they are handling the healthcare specifics.nnTraditionally, healthcare revenue cycle management includes delays in the patient’s treatment and care and it is also associated with the long-winded claims submission process.nnHowever, it is important to ensure the RCM process in a timely manner in order to provide proper care or treatment and medical training.n

Why is Effective Revenue Cycle Management Crucial?

nOn the extreme side of Revenue Cycle Management, there is an issue of outstanding payments that will lead the healthcare providers to bad debt. Managing the collections process is not always easy, it will distract the concentration away from providing valuable care and treatments to the patients.nnMost of the providers consider bad debt as a potential revenue loss. However, efficiently managing revenue cycle management process steps may help healthcare providers to decrease the number of matters that will lead to bad debt. Moreover, all the problems must have a solution.nnOne powerful solution to resolve this issue is to contact a third-party Healthcare revenue cycle management company.n

What Does Revenue Cycle Management Cover?

nAccording to HFMA, there are some factors involved in the revenue cycle management of the healthcare organization:n


  • Charge entry, claim submission, and daily submission
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  • Electronic submission and remittance
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  • Payment posting and payment hunting
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  • Insurance follow up, denial management, and appeals submissions
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  • Patient billing and services
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  • Practice analysis report
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Reasons Why Revenue Cycle Management Is Important?

nHere are some reasons why Revenue Cycle Management (RCM) is important for your practice with respect to the size and specialization.n

Streamlined Billing Process:

nApparently, an adequate billing and payment process is the main focus of the healthcare providers in order to robust the revenue stream.nnHowever, by partnering with a third party, you can save your time and administrative costs. Efficient healthcare revenue management processes can lead to maximizing payments by proper handling of claims rejection and denials. Revenue cycle management streamlining process includes:n


  • It simplifies the process by providing clear terms of the billing and payment collection cycle.
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  • Uses EMR/PMS software to enter the patient information and demographic data.
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  • Revenue cycle management software submits an electronic eligibility request to the insurer.
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  • Resolves authorizations and verification problems through electronic modules.
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  • Involves the Electronic scrubbing process to capture errors before the claim submission.
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  • Monitoring the submitted claims regularly.
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Adopting Healthcare Technologies:

nThe federal government has made electronic records, and the use of information technology mandatory for effective revenue cycle management, and to make more efficient data management.nnHowever, outsourcing revenue cycle management to medical billing specialists saves providers time in figuring out how to integrate software programs.nnAll these processes are properly configured through digital records and enable the healthcare provider to focus on patient care. Moreover, it reduces the significance of the time of paperwork which is held necessary for revenue cycle management.nnWhile the future of healthcare organizations completely relies on information technology. However, changes in the medical billing and coding process are essential for every size of the healthcare organization.n

Helps in Establishing an Effective Financial Policy:

nIn large organizations, policies are sometimes disorganized when each department creates its own guidelines to resolve the issues.nnA proper financial policy regarding insurance coverage is necessary for the smooth running of revenue cycle management, it not only informs staff about various expectations but also helps patients in the collection of copayments and balances.n

Successful Revenue Cycle Management Process Steps:

nWant to run a successful management process. Let’s have a look at some successful steps:n

Improving Front- End: 

nOne of the most effective ways to improve your revenue cycle management process is to review your front-end operations that will help the healthcare providers to move their claims forward and identify the possible errors to maximize the revenue.nnMoreover, it is important to ensure that there is no mistake in the patient’s balance account because this will end up causing problems and ultimately affect your revenue cycle management and claims reimbursements.n

Verify Insurance Eligibility:

nIf the patient’s insurance is not verified at the start then it can cause problems in the future. However, it is important to ensure patient eligibility in order to reduce denials and revenue losses.n

Training Staff:

nBy training your staff you can reduce the number of problems that will help the healthcare providers to streamline their front-end and improve clean claims.n

Let Us Handle Your Revenue Cycle Management Operations: 

nMED-Miles LLC has a team of professionals who are in the healthcare industry for more than 8 years with the view to providing healthcare providers revenue cycle solutions and services at a reasonable cost.nnSo, if you think of protecting your revenue cycle management then contact MED-MILES LLC today at +1 888-598-9181. Let our expert team handle your revenue operations.

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