Revenue Cycle Management (RCM) – Importances, benefits and its Challenges
Revenue Cycle Management (RCM)

Revenue Cycle Management (RCM) – Importances, benefits and its Challenges

Revenue Cycle Management or RCM is generally defined as the process of handling various business claims, processing various invoices, and generating revenue specifically in the healthcare industry. RCM begins right when a patient makes an appointment and it continues till his account balance becomes zero. The process includes various steps like checking the patient’s insurance eligibility and claims.

What is Revenue Cycle Management

Revenue Cycle Management is essentially the combination of all financial processes involved in the healthcare industry. It is one of the core components of a health information management system.

In order to run a successful medical practice and healthcare institution, it is important for healthcare providers to come up with an accurate and efficient billing procedure. Only by establishing core accounting protocols, healthcare institutions will be able to take care of the reimbursements and other fee-for-service payments.

Revenue Cycle Management system in Healthcare

Healthcare institutions have started relying on various revenue cycle management systems for better revenue management. A healthcare revenue management system should be comprehensive and flexible, this improves its effectiveness. The healthcare industry is undergoing many severe changes in the US and Atom one of the best options to choose from is helping various healthcare institutions manage their revenue better.

Atom provides the exact and updated data through a combination of various data capture and by directly reaching out to providers. Regardless of whether you run a multi-location hospital or a  one-doctor clinic, a revenue management system is essential. RCM helps any healthcare institute run its business properly by ensuring the organization is being paid for the services it is providing.

RCM | Atom Healthcare
RCM | Atom Healthcare

Factors involved in Revenue Cycle Management

No matter how efficiently your team is working, you can’t keep the lights focused on the quality of service you are offering. It is incumbent for you to look into the financial aspect of your business as well. This is why it is important to understand healthcare revenue management and the factors involved. 

RCM starts right when the patient is admitted to the hospital, however, involves checking the eligibility, verification, claim submission, and final payment. Reporting plays a very important role in revenue management, you need to generate various reports based on your needs. With Atom, the entire process becomes extremely easy and you will be able to produce customized reports including financial figures.

Factors that affect Revenue Cycle Management 

Revenue Cycle Management is the backbone of any profitable medical institution. However, there are many physicians who struggle with managing the finance part of their business properly. Below we have listed some of the major issues that affect revenue cycle management on both small and large scale.

  • The communication gap between the physician and the manager: Often it is a disconnect between the office manager and the physician. There should be at least one meeting every week to maintain smooth communication and revenue management.
  • Untimely or no follow-up at all: This is another major issue that is noticed in most healthcare institutions. Surprisingly, many physicians leave the money sitting on the table and don’t follow up. Inconsistent or improper follow-up leads to loss of revenue which in turn affects the organization’s growth. 
  • Lack of training:Each staff working for the revenue cycle management should have the minimum level of training. They should have a clear understanding of the process and how is it beneficial for the organization. Often it is noticed that staffs lack the minimum knowledge required and fail to perform their level best.

RCM Analytics

A revenue cycle managementis designed to help any healthcare institute manage its in a better way. Atom focuses on curating 100% accurate reports that are tailored based on different needs. This gives the user the power to identify and remove barriers to earn more revenue. 

Success in the healthcare sector is a lot more than just operational performance. With RCM analytics, you will be able to achieve the best-in-class performance and identify the areas that need improvements. Also, you will be able to get a clear view of the administrative and financial parts of your business. 

Revenue Cycle Management Service Challenges

If you have ever worked in any healthcare organization, you already know the importance of medical claims and how revenue cycle management makes the entire process easier. The administrative and revenue management system of any healthcare organization is very different. However, almost all healthcare organizations face a similar issue in managing their revenue, we have listed some below:

  • Compliance standards
  • Coding and Billing
  • Maintaining a continuous cash flow
  • Irregular data analysis
  • Irregular follow-ups
  • Improper staff training

Benefits of RCM

Medical billing and revenue management is complicated. It often becomes overwhelming for staff to maintain 100% accurate reports when all the time. Revenue cycle management has various levels, each connected with the other.

Below we have listed the benefits of RCM:

  • It helps in improving patient’s account verification.
  • Helps in improving the billing process
  • Helps in providing unmatched customer service and experience.
  • Allows the healthcare organization to take advantage of the cash flow opportunities
  • Minimize cash flow gaps.

Few FAQs on RCM

  • Why is Revenue Cycle Management important in the healthcare sector?

    The Healthcare sector is one of the largest industries and when it comes to any particular healthcare organization, there are multiple patients. It often becomes difficult for organization owners to keep a track of the revenue they are earning. It helps in the proper utilization of the funds and selecting the right plan to increase overall revenue.

  • What are the RCM strategies to increase revenue?

    RCM typically is an entire cycle and involves various steps. Here are some of the strategies that can help to increase the revenue of any healthcare institute. 

    • Making technology your friend and understanding the RCM system being used.
    • Keeping an emergency plan ready that can be used during an emergency.
    • Coming up with a proper follow-up to keep a track of all insurance claims.

  • What are the quality checks in Revenue Cycle Management in Medical Billing?

    Performing a quality check helps in understanding its effectiveness. Below we have listed some of the important quality checks in RCM:

    • Cost of revenue collection.
    • Regular audit
    • Maintaining accounts receivable

  • What are the 10 steps in the medical billing cycle?

    Below we have listed the steps involved in medical billing:

    • Patient registration
    • Perform eligibility test
    • Bill creation
    • Submitting the claims
    • Claim follow up
    • Generate statements
    • Payment collection
    • Reporting

  • How can revenue collection improve the quality of healthcare services?

    Healthcare institutions are not only about the medical service they offer, but it is also a business. With the help of proper revenue management and collection system, the entire follow-up process becomes easier. It helps in improving the quality of healthcare service because of the continuous cash flow. 

Revenue cycle management plays a crucial role in managing the financial part of any healthcare institution. The number of patients in any healthcare organization makes it difficult to keep a track of insurance claims. Atom is one of the best RCM systems available and its usage will surely help the revenue management of any healthcare organization.

What are your thoughts on RCM and its importance?

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