Revenue cycle management (RCM) is the process of handling claims, or it could be defined in other means as it is also the process of processing payments and generating revenue in the healthcare industry.
Revenue cycle management starts once the patient books an appointment with a physician or a medical professional. Once they step in the facility the cycle starts and it continues until the balance on the account related to this patient goes to zero.
The process includes a lot of steps that vary from checking the eligibility of the patient’s insurance to verifying the coding claims. It is a complicated process that needs a lot of management and mistakes in it hurt a lot of groups involved in the process. Mistakes in the process will hurt the patient and make them worry about their insurance coverage and at the same time it will make the medical facility worried and reduces the cash flow which will affect the hospitals or the medical facility’s day to day operations.
The RCM Services includes all the administrative and clinical functions that contribute to the management, capture and collection of the patient service revenue. As said before the revenue cycle is complicated and involves a lot of steps, here are some of them that outline its importance:
- Rendering medical services into charges that are billable and capturing the charge.
- Properly align the diagnoses and the procedures with the proper code to avoid any unnecessary mistakes.
- Submitting the claims of the billable fees to insurance companies
- Collecting payments from the patient’s and determining their balance
- Before a patient arrives, some information collecting takes place to ensure the patient is covered by an insurance company.
- Registration process then takes place to collect subsequent patient information during the registration to establish a medical record number and meet regulatory requirements
- The remittance process then takes place to apply to reject payments.
- Collecting payments from third part insurers then takes place
- Utilization review then takes place.
These steps are necessary for every patient that comes through the doors because everything needs to be done properly and every patient needs to have his whole process and cycle go smoothly and done right, so you can imagine how hard it might be or how exhausting the process may be for every patient, especially for medical facilities or hospitals that cover thousands of citizens and patients in major cities.
With a proper management cycle, a well-designed system will be in place to track patient care and the collection cycles properly. It bridges and connects the gap between the business and clinical sides of healthcare. It reduces the time needed for receiving the payments.
This cycle enables organizations to check where the revenue process has the scope of improvement by arranging billing data properly and producing reports.
This is why a lot of organizations have started outsourcing their revenue cycles process to countries where it will be cheaper to get their revenue cycle management process done and it will also be done with a higher quality than hiring locals.
Why outsource it?
Revenue cycle management can be a very tough process and very time consuming. But still every organizations related to medical procedures need to have this kind of cycle for every patient they get.
It is necessary and unavoidable. It needs to be done correctly and efficiently to avoid any coding mistakes that may cost the organization money and cost the patient time and money and cause him or her a lot of inconvenience.
The steps in the cycle may be hard to manage especially the medical coding process. This is why organizations use services in countries like India that cost way less and still get the job done efficiently and right through professional coders and healthcare professionals.
Here are some of the benefits of why you should outsource your revenue cycle management processes:
When you outsource your revenue cycle management you will have greater control. There is a common misconception that outsourcing will lead to lost control over the process and your money. But the fact is, outsourcing RCM gives doctors a better understanding of the revenue cycle because it delivers transparency and facilitates relations ships with experts.
We always hear about patients’ information being leaked and causing a lot of identity theft and a lot of inconveniences for the patients. All those leaks happen because of weak security systems that are easily breached. What patient or organization want to have their patients’ info not secure enough and easily accessible by thieves or hackers. That’s why you start outsourcing because it makes the whole process more safe and secure. Outsourcing companies spend a lot of their resources setting up better security systems and keeping up with the latest updates to ensure high security and keeping the organizations info in check and safe from any breaches or leaks. No one wants a patient who is worried about getting better also worried about their information getting in the wrong hands. Not to mention the lawsuits and legal trouble an organization will get in if they happen to have any security breaches.
Outsourcing companies will always be up to date with the latest regulations and policies in your state or country. They perform everything according to your needs and your state’s policies. A good outsourcing partner will provide you with exactly what you need according to the conditions you reside in. They will help your practice keep up with the changing conditions and the vast world of healthcare regulations.
Stronger financial performance
Not only will the outsourcing companies like Axiom help you increase the cash flow and make sure the submissions are not rejected or there are any problems with the insurance.
They will also help you increase your revenue and improve your organizations financial operations. Outsourcing your revenue cycle management will help you decrease the need for office space and billing procedures or internal staff and office infrastructure. They will help you receive more of the payments your organization is entitled to get.
This will lead to less capital expenses and going through a tough hiring process that will cost you a lot of time. A good outsourcing partner like AxiomBPM will help you by reducing the time you need for processes like this and ensure that you can spend your time improving your bottom line and providing a better care for your patients making them happy, satisfied and more importantly cured.
What are you waiting for? Outsource your revenue cycle now. You don’t need to waste time and worry about insurance companies rejecting claims anymore.
We will make sure the rate of claims refused is reduced and increase your cash flow so you can live through your day to day operations, all that while costing you less and saving you time. What is there to not like?
Contact AxiomBPM now for an improved financial situation and a better management process for your medical practice.