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Revenue Cycle  Management For Healthcare

Revenue Cycle Management Solutions and Services

Revenue Cycle Management (RCM) in healthcare refers to effectively managing a series of steps of patient care, starting with the initial inquiry of the patient and ending with proper payment for care. Appropriate information is collected and documented, third-party payers and patients are billed correctly for care, and payments are collected. The entire process entails many touchpoints.  Mismanagement of any of these processes can lead to lower patient satisfaction and loss of revenue.

A consistent RCM process and hiring a revenue cycle management consulting company have many benefits.

These include:

  • Increase in Claims Paid After First Submission
  • Increase in Practice Collections and Revenue
  • Increase in Focus on Quality Care and Patient Outcomes
  • Improved Patient Experience and Referrals
  • Decrease in Administrative Burden

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Revenue Cycle Management Process

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.

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Types of Medical Practices We’ve Helped With RCM

Larsen offers a suite of revenue cycle management services for the following medical practices to help them provide better client experiences and capture more revenue.