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The Significance of a Medical Revenue Cycle Management System

medical revenue cycle management

The Significance of a Medical Revenue Cycle Management System

The medical revenue cycle management system refers to the method of managing claims, properly processing payments and ultimately and most importantly, generating revenue for the health-care industry. It starts at a time when the patient might want an appointment and it continues till the time all the revenue in his account is equal to zero. This entire process is made up of several small processes which includes, checking eligibility of the patient for insurance as well as coding claims.

Here are the advantages of having a functional medical revenue cycle management:

  • A RCM system which has proper cycles for billing and collection are utilized for proper billing and collection cycles. This is done by registering at first, getting a proper appointment, scheduling and finally carrying out the whole payment process.
  • With proper assistance of RCM, it helps in the communication with the EHR and the accounting systems have also become relatively simpler.
  • It accounts to helping to bridge the complete gap in between the clinical and business sides for health-care.
  • It also takes time while providing services and voluntarily collaborating with the other IT systems which are billing systems and efficient electronic health record.
  • RCMs also make sure when can an organization invest in analytic software and also use dashboards to determine and also analyze the total revenue goals.
  • It also allows health-care staffs when to check whether the revenue cycle might have any scope for improvement by dealing out proper billing data and also putting together corresponding reports on the same.

The common problems with the medical revenue cycle management are:

  1. The staff is not always well trained or educated while optimizing the revenue cycle. Several coding errors or faulty data entry may simply create a big failure on the overalls.
  2. Lack of optimum communication in between the staffs is also a pressing issue while understanding the complete medical revenue cycle management. The communication flow in between the office managers and physicians must be open at all times and also weekly meetings need to be held to review the collections, revenue and receivables of different type.
  3. Poor work-flow: Without a very efficient and well-established work-flow process it is not possible to check the eligibility of a patient before a patient arrives. The staffs might miss our on steps and forget important tasks which would end up in increased errors.

However, if the above mentioned issues are successfully overcome, then this system can result in maximized revenue and decreased rate of bad debt write-offs.