You must have heard the term RCM. What does RCM actually mean?
It is the process that healthcare providers use in their practice to manage the financial side of the business. It goes from making appointments to filing insurance claims and confirming that people have made their payments.
Get into this informative article, where we will explain what RCM is in medical billing, how they both relate and what the benefits of RCM healthcare are.
What is RCM in Healthcare?
This term refers to the financial management process of a healthcare delivery system that deals with patient revenue. It involves all the processes that healthcare organizations have to follow to capture, record and manage the payments for the services that are offered.
The RCM cycle in medical billing begins right from when the patient books an appointment or simply turns up at the doctor’s office. From there, the healthcare provider gathers fundamental information like insurance information and then verifies if the patient’s insurance allows for the acquisition of the services required. Following the appointment, services that have been availed are coded, and claims are made for reimbursement.
Simply put, RCM healthcare services help healthcare organizations get paid for services delivered in a coordinated manner. As a result of poor RCM, healthcare providers could lose their revenues, make billing mistakes, and have dissatisfied patients.
How is RCM Linked to Medical Billing?
As mentioned earlier, RCM is closely associated with medical billing. Medical billing is an essential component of the RCM healthcare process through which providers can receive money for the work they do.
The RCM process can be defined as a cycle that begins when a patient books an appointment until the time of payment collection. Medical billing starts when the patient has paid their copy and left, and the healthcare provider has to submit their bill to insurance for payment.
If a proper RCM system is not present, medical billing could be a total free-for-all, which would definitely lead to lots of non-payments, wrong charges, and general annoyance for healthcare providers and patients. Therefore, RCM maintains the correct order out there and guarantees correct charging.
Benefits of Healthcare Revenue Cycle Management
It has the following advantages, however some of the key advantages of implementing RCM:
Improved Cash Flow
Thus, RCM plays an important role in making payment collection faster and reducing cycle time. This way, healthcare providers will be able to reduce the time between the claim and payment and quickly eliminate revenue loss, leading to a steady cash flow.
Reduced Billing Errors:
The problem of mistakes is a real concern when it comes to medical billing since it often results in claims pending, being denied or long delays in reimbursement. RCM avoids some of these errors since it enables claims to be coded and submitted in the first instance, heading towards reducing common mistakes that impact revenue.
Better Financial Visibility:
The RCM system always enables healthcare providers to have a clear vision of the organization’s financial performance. From them, they can monitor outstanding claims, payment statuses and areas that require changes.
Whenever billing structure and details are decipherable, then it becomes unlikely for patients to be frustrated by their bill forms. By using RCM, the correct billing can be initiated and done on time and the patients gain trust in the hospital.
Compliance with Regulations:
Healthcare billing comes with lots of holes and holiness. RCM also aids in maintaining compliance with these regulations, so penalties for not adhering to correct processes are eliminated.
Focus on Patient Care:
As a result, both overall billing and managing finances will be made easier, allowing the concerned healthcare providers to concentrate on the much-needed patient care. RCM helps the staff to work fewer hours on billing and more hours focusing on their patient’s needs.
Conclusion
So, it can be understood that RCM is important for healthcare practices as it assists them in reducing working expenses, enhancing their overall income, and providing mammoth comfort for the patients and the healthcare providers as well. It’s a vital tool in any healthcare management organization that seeks to thrive in the market.
Moreover, outsourcing your medical billing system to a trusted company like DWP Medical can help you improve your finances and make better terms with patients!
FAQs
Does medical coding come under RCM?
Indeed, medical coding plays an essential role in the framework of the company’s Revenue Cycle Management (RCM). It means converting services provided in the healthcare industry into different code sets that will be charged on the bill.
What does RCM stand for?
Revenue cycle management is an abbreviation for RCM. It means a process through which healthcare providers can handle every aspect of financial flows that are associated with patients. This includes all the basic operations such as setting appointments, checking insurance details, making claims, billing and/or receiving payments for unpaid balances.