Transform financial performance and improve patient experience with revenue cycle management
The method of managing the billing, payment processing, and denial management is known as Revenue Cycle Management (RCM). The cycle starts with Scheduling /Booking an appointment of a patient and concludes with receiving payments from insurance company and patient. In certain situations and realms, such as healthcare, the process is complex and more difficult. Hospitals and health services use the healthcare revenue cycle to handle all of the administrative and clinical data that falls into the facility regularly. Also for hospitals that have the best management tools, this can be a very difficult and time-consuming procedure that requires a lot of data being threaded through various hospital departments. As a consequence, collecting the most reliable data is crucial to good management. The healthcare revenue cycle is a set of administrative and clinical activities that lead to the capture, management, and collection of patient service results. In other terms, it is a term that applies to a patient’s entire credit history, from registration to bill payment.
Before claim submission, the information about the patient needs to be captured. This happens before the first appointment. Also, eligibility and insurance coverage will be confirmed. Collecting the patient responsibility upfront while the patient is taking the service is an important aspect. .
The claim is taken into consideration, along with the charges, these are entered and coded. Later the claim is submitted to the patient’s insurance.
This is the stage that involves the management of the claim and following up on the response from insurance. It also includes posting relevant payments.
The receipt of payment from the patient (if applicable) is sought during this process. This may entail making declarations and, if appropriate, submitting the bill to collections.
Finally, data from the RCM programme can be collected and analysed by the billing staff.
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