Healthcare revenue cycle management is a process that starts when healthcare providers submit bills for services rendered and ends when the payers remit payment for those services. Several phases must be completed accurately and timely to ensure that the providers receive the payments they deserve. Let’s take a closer look at each of these phases.
Phases of Revenue Cycle Management in Healthcare
Revenue cycle management is a process businesses use to track and manage the flow of money coming in and out of the company. The revenue cycle has four phases: collection, billing, accounting, and payments. Each phase is important for ensuring that the company receives service payment.
Billing
Billing is a critical part of revenue cycle management. It is responsible for ensuring providers are reimbursed for their services. Billing also helps ensure patients receive the correct treatment and services. Billing must be accurate and timely.
Verification of Details
Detail verification is an important part of the revenue cycle management process. It involves verifying that all information is correct and up-to-date. By confirming details, practices can avoid costly mistakes that can impact revenue. Detail verification helps to ensure that the correct information is being sent to the correct places, which helps to improve accuracy and efficiency.
In the process of detail verification, revenue cycle management verifies many things, including insurance of the patient and eligibility criteria to avoid claim denials and delayed payments, etc. All these aspects must be considered to ensure that billing is done correctly.
Coding
Coding is one of the most important aspects of revenue cycle management. Coding helps ensure the correct procedures are being billed to the correct payers. It helps to improve accuracy and efficiency. It is also important to ensure that the correct codes are used to describe the services provided. Providers can avoid claim denials and delayed payments using valid codes.
Claim Filing
Claim filing is an important part of the revenue cycle management process. It is responsible for submitting bills to the appropriate payers. By doing so, providers can ensure that they receive payment for the services they provide. In order to be successful, claim filing must be accurate and timely.
Claim Denial Management
The denial management phase of revenue cycle management is responsible for handling any claim denials that may occur. This includes identifying the reason for the denial and taking the necessary steps to correct it. Denial management also helps to improve accuracy and efficiency by identifying any potential problems with claims filing.
The aspect denial management also looks after second bill reviews. If the claim is denied then providers send a second bill with some changes. The RCM reminds you of the dates and important statute of limitations that you should consider before filing a second bill review.
Negotiation and Collection
Negotiation is an important part of the revenue cycle management process. By negotiating with payers, providers can ensure that they receive the payments they are owed for the services they provide. In order to be successful, negotiation must be accurate and timely.
The collection phase of the revenue cycle management process is responsible for ensuring that providers receive payment for the services they provide. The process of collection involves contacting insurance providers and requesting payment for the services their insuree has received. By doing so, practitioners receive payment for the services they provide.
Managing Cash Flow
One of the most important aspects of revenue cycle management is managing cash flow. It helps to improve accuracy and efficiency, which in turn helps to improve cash flow. In addition, RCM can help providers to negotiate better payment rates with payers. By tracking the flow of money, providers can ensure they receive the reimbursements they are owed for their services.
Reporting
Reporting is an important part of the revenue cycle management process. RCM helps providers identify any potential billing problems by tracking the cash flow. It helps to improve accuracy and efficiency, which in turn helps to improve reporting. In addition, RCM can help providers generate reports that can be used to improve their revenue cycle management process. These reports can help providers identify areas where they may need to make changes to improve their revenue cycle.
To Sum Up
If you’re looking for a way to improve your healthcare revenue cycle, consider working with an RCM company. It can help you to manage cash flow, identify potential problems with billing, and negotiate better payment rates with payers. In addition, it will help you to generate reports that can be used to improve your revenue cycle management process. Contact us today to learn more about how an RCM company can help your business. We would be happy to answer any of your questions and discuss how our software can help you achieve success.
