What is revenue cycle management? |Billmymed


To simplify revenue cycle management is the process of managing a patient’s healthcare revenue. It includes checking the insurance eligibility of patients, making and submitting claims, and collecting payments.

Revenue Cycle Management is one of the most important functions within healthcare organizations or practices today because it affects every other department within an organization or office. RCM involves processing invoices, reconciling accounts receivable reports, and establishing collection strategies for unpaid bills. The goal of RCM is to maximize collections while minimizing debts written off by providing excellent customer service and thoroughly following up on the claims submitted to insurance through effective communication channels such as phone calls or email messages; resolving billing errors promptly; avoiding duplicate payments when possible.

Revenue Cycle Management (RCM) is a complex process that requires coordination between many different parties, including physicians/ healthcare, providers, in some cases hospitals and health systems, laboratories, and pharmacies.

In this article, we’ll explore what RCM means for your healthcare organization and how you can use it to improve your financial bottom line.

The Revenue Cycle And Its Components :

The revenue cycle is the process of managing patient accounts and collecting payments from them or from insurance companies. It includes a number of stages and components, all of which are critical to ensuring that your hospital or clinic has the funds it needs to continue providing quality care.

The Different Stages Of The Revenue Cycle Are:

Eligibility Verification :

Any good billing company would look at the Doctor’s schedule and check insurance coverage and eligibility of the patient prior to the scheduled appointment and make the doctor’s staff aware if any co-pay or deductibles are to be collected from the patient. This would ensure the minimal build-up of Accounts Receivables.

Charge Capture:

This step involves accurately recording all services and supplies provided to patients and ensuring they are correctly coded and billed to the payer- which may be the insurance company or the patient.

Claim Submission:

This step involves submitting the claims to the insurance company or other payers for reimbursement. The claims should be submitted in a timely manner with all necessary information and codes to ensure timely payment.

Payment Posting:

This step involves processing payments received from the payers, posting them to the patient’s account, and reconciling any discrepancies. Accurate payment posting would enable the service provider to easily see true financial health of their practice.

Accounts Receivable Management:

This step involves monitoring the status of outstanding claims and ensuring timely follow-up with insurance companies or other payers to ensure payments are timely and fully received.

Denial Management:

This step involves identifying the reasons for denied claims and taking the necessary steps to resolve them, including resubmitting the claim, appealing the denial, or negotiating with the payer/ insurance company.

Why use revenue cycle management services?

Revenue cycle management is a way to bring in more money, faster. It can also help a provider to:

Save money by reducing costs and increasing cash flow, which means the healthcare provider will have more resources available for other important things like hiring new employees or investing in new technology.

Reduce risk by ensuring that all of the patient’s bills are being processed correctly and timely so that no money is left behind on the table due to a billing error or delay.

Improve patient satisfaction by effectively communicating to them the treatment costs and the amount of money that they might have to pay out of their own pocket. And finally, to increase collections by identifying gaps in revenue collection processes so they can be fixed before they turn into problems later down the road resulting in lost revenue).

Why choose a medical billing company for your revenue cycle management needs?

Revenue cycle management is a complex process that requires specialized knowledge and expertise. If you want to ensure that your revenue cycle management is handled efficiently, it’s best to hire a professional medical billing company.

Medical billing companies have the expertise and experience needed to help you reduce costs, reduce denials, improve patient satisfaction, and increase cash flow for your practice. Medical billing companies can handle all aspects of a practice’s billing needs including:

Billing services for insurance companies

Claims processing for government programs like Medicare/Medicaid or Veterans Affairs (VA) health care benefits programs

Patient accounting services such as credit card payments or self-pay accounts


It’s important to note that RCM is not just about collecting money from patients. It’s also about improving the overall patient experience and enhancing your hospital or clinic’s reputation in the community as an organization that actually cares about its patients. Good RCM can help build trust between your practice and its customers, which is extremely important when it comes time for them to critical decisions like choosing which doctor they want to treat or where they should go for surgery. The best way to do this is by making sure each person who walks through your doors feels valued as an individual–not just another number on a bill!

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