Revenue Cycle  Management For Healthcare

An effective healthcare revenue cycle management process ensures that every interaction with a patient, from initial inquiry to final payment, is effectively managed to provide the best patient experience and prompt payment. The RCM process typically includes the following steps:

1. Patient registration: This involves capturing the patient’s demographic information, insurance information, and other necessary details.
2. Insurance verification: This step involves verifying the patient’s insurance coverage and benefits eligibility and obtaining any necessary care authorization.
3. Focus on Value-Based Care: This step involves providers’ thorough clinical documentation, focusing on high-quality patient care, and providing routine reporting on clinical care metrics. 
4. Coding and billing: This step involves assigning the appropriate medical codes to the services provided and submitting claims to insurance companies for payment.
5. Claims processing and payment: This step involves tracking the progress of claims and ensuring that they are processed and paid on time.
6. Accounts receivable management: This step involves monitoring outstanding balances, following up with patients and insurance companies for payment, and managing collections.