Revenue Cycle Management (RCM) refers to the process of identifying, collecting, and managing the practice’s revenue from payers based on the services provided. A successful RCM process is essential for a healthcare practice to maintain financial viability and continue to provide quality care for its patients.

The move toward value-based reimbursement and more holistic patient care has required healthcare providers to take a closer look at the way they approach revenue cycle management. Poor billing practices can result in financial losses and potentially put at risk the ability to deliver quality care. Striving to improve and streamline core operational procedures can help providers remain financially viable.

CHALLENGES

The revenue cycle begins when the patient makes the appointment and ends with successful payment collection. However, there are many steps in between  that must be accurately and efficiently completed to ensure timely payment. The opportunities for human error due to coding complexities, miscommunication, medical billing errors due to duplicate data, and missing information or misspellings can result in lost revenue.

FACTORS THAT CAN AFFECT RCM

• COLLECTING PATIENT PAYMENTS

• FRAGMENTED ADMINISTRATIVE PROCESSES

• ELIGIBILITY ISSUES

• LACK OF DIGITAL WORKFLOW

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