RCM-Revenue Cycle Management

In a nutshell, it means taking steps to assure that you get paid for what you do and that you get paid in a timely fashion.

The revenue cycle starts when the patient calls your office for an appointment and your staff captures the patient’s name, phone number, and maybe the name of their insurance company.

The cycle ends when the balance on their account is zero.

RCM is the process of managing claims, payment and revenue generation. RCM encompasses everything from determining patient insurance eligibility and collecting co-pays to properly coding claims.

So, four steps to effective revenue cycle management: gather data, verify eligibility, use the right numbers, and automate as much of the process as possible. That’s the way to a zero accounts receivable balance!

  • Data Gathering Is Crucial
  • Verify eligibility
  • Emphasis on Accurate Data Entry
  • Automate More (e.g. E-billing: electronic claim submission and electronic remittance payment posting).

The quickest way to a zero balance is to automate those tasks that do not require your billing staff’s expertise and to use that expertise to communicate with the payers as needed.

The revenue cycle process is enhanced with electronic claim submission and electronic remittance payment posting.