12h Dec 2018
Estimated reading time : 7 Minutes
IMPORTANCE OF RCM IN HEALTHCARE INDUSTRY
What is RCM?
Revenue-cycle management (RCM) can be defined as the process of handling claims, processing payment and generating revenue in the healthcare industry. Itis about how an organization handles finances and processes associated withdifferent steps of patient care, beginning from the time when a patient makesan appointment to seek medical services and endingafter all the claims and payments have been collected and the balance on patient’s account becomes zero.
Revenue cycle management is an important term and the processes involved in RCM have a significant impact on functioning of healthcare industry. Healthcare organizations need to have their policies and practices in place for remaining financially fit and RCM plays a vital role in how organizations can operate on a day-to-day basis.
When a certain amount of revenue is generated, you must ensure that expenses don’t exceed that particular revenue amount. It seems basic but people don’t look at it that way
Why RCM is important?
- A well-designed and proper RCM system streamline the billing and collection cycles, by accurately registering, appointing, scheduling and processing the payment.
- Communicating with accounting systems and EHR becomes easier with the help of RCM.
- Revenue cycle management links administrative data (patient’s name, insurance provider, other personal information) along with the treatment received by a patient.
- It bridges the gap between the business and clinical sides of healthcare.
- Healthcare providers take help of revenue cycle management systems for preserving and managing patients’ billing records.
- It improves the turnaround time associated with offering a service and receiving payment for it by interacting with EHR systems and billing systems and also reduces administrative costs.
- RCM is responsible for all administrative tasks including informing patients of an upcoming appointment, reminding patients and payers of an existing balance and questioning insurers, when a claim is denied.
- It saves providers time and money by reducing the amount of denied claims and also by enabling patients to pay their bills online.
- It allows healthcare staff to enter all the information required for claims processing, and avoids the revision or resubmission of claims.
- The organization can also check where its revenue cycle has the scope of improvement by arranging billing data and producing corresponding reports.
How to improve RCM?
- Bridging the gap between the business and clinical sides of healthcare
- Comply to Healthcare Standards
- Outsource or Leverage the expertise of well known Healthcare service provider
- Adapting to technological development and Maintaining consistency between health systems
- Ensuring Patient centered approach
- Modify and lessen inaccurate data
- Taking professional help for smooth functioning of RCM
