The service sector of medical billing and/or revenue cycle management is flourishing rather successfully over the last few years. It has some significant reasons too!

While hospitals, small clinics, and larger healthcare systems are busy saving lives and treating their patients, every healthcare organization is equally worried about getting paid for its services. Without a doubt, this is equally important as they also need funds to manage their resources, service providers, and caregivers. They need to develop successful procedures and policies that can help them to stay financially healthy. Probably, here the healthcare revenue cycle management comes in with all its features and facilities.

What Is Revenue Cycle Management (RCM)?

The experts describe it as a dedicated financial process that involves a system of software and professionals that is primarily engaged in collecting payments for medical bills for a healthcare organization. The system combines a wide array of data that include personal information about the patient along with financial billing information. The patient information includes personal information about the patient along with the insurer’s name and codes related to the treatment the patient is billed for.  To ease the process and minimize the complications, the health organizations use a centralized billing and coding system that enables 100% trustworthy reimbursement, agreement, and medical processes.

Steps Involved In a Successful Revenue Management System:

Every dedicated revenue management system works on a few specific steps. These steps include:

• Charge capture
• Coding
• Claims submission
• Insurer communications
• Payment collections
• Medical service review

Every dedicated provider of medical billing facilities and revenue management systems takes care of all the necessary steps that are involved in the process. They put all the possible efforts to make the system work fine so that the patients do not get overcharged and the doctors or the medical establishments get their dues cleared.

RCM SOLUTIONS INCLUDE:

Suitability & Profit verification: By calling insurance and using technology, our professionals do everything possible to provide the information that you need to serve the patients. We can do this for upcoming and the same day appointments as well.

Pre-Authorizations: Our experts complete verification of all the services for pre-authorization for procedure codes, drugs, including copay and coinsurances.

Payment Posting: Once we receive the payment from insurance companies, we do the needful to settle the claims. Our team identifies the claim denials and underpayments of a claim.

Denial management: By outsourcing your outstanding claims payment collection for complete recovery. Our team pursues every claim to its rational conclusion and provides you detailed reports on activities for each claim maximizing your revenue.