Services

Revenue Cycle Management

Understanding the healthcare revenue cycle

Revenue Cycle Management is the term given to a financial process, encompassing management of funds as well as collecting payments for the treatment a healthcare provider offer your patients. No matter how excellent a job your team is doing in your medical practice, you can’t keep the lights on and the doors open just based on the quality of care being provided. It’s incumbent on you to pay close attention to your financials, too. Those organizations that fail to stay on top of the level of revenue they’re bringing in could find themselves scrambling to remain viable while other practices around them are actually thriving. This is why it’s so important to understand the healthcare revenue cycle and the steps it entails.

Revenue cycle management (RCM) is the process of handling billing, payment processing, and revenue collection. A revenue cycle is a repeating process that begins with billing a customer and ends with collecting patient payments or writing off the bill. For some organizations, such as retail stores, this can be achieved instantaneously. In others, such as healthcare, it is a more complex process.

Sagewood Medical Practice Management’s RCM team delivers a broad range of services to it’s valued customers encompassing all of the aspects of managing a practice. From the initial implementation of the system to the all-important contact with the patient to the collection of the final dollar, we work with each Client to address and improve the people, processes and technology that impact their Revenue Cycle.

How Does Revenue Cycle Services Fit Into Health Systems?

It probably comes as no surprise that RCM is critical to the lasting success of any healthcare organization. The revenue cycle for a health business includes the following steps:

Claim Preparation

Before submitting a claim, the patient’s information needs to be captured. This typically happens before the first appointment, in the case of anesthesia providers it occurs on the day of surgery. Additionally, the patient’s eligibility and insurance coverage will need to be confirmed.

Claim Submission

During this step, the claim is created, the charges are entered and coded, then the claim is submitted to the patient’s insurance.

Claim Management

This stage involves managing the claim during and following the response from insurance. It also involves posting any relevant payments.

Receivables Collection

During this step, the collection of the payment from the patient (if relevant) is pursued. This can involve issuing statements and sending the bill to collections, if necessary.

Finally, the billing team should collect and analyze data from the RCM software. RCM systems can minimize the number of errors, increase the likelihood of payment, and avoid aging accounts receivable. Additionally, it strives to increase claims efficiency while reconciling costs against revenues to optimize cash flow.

Sagewood Medical Practice Management's Revenue Cycle Management Brings Passion And Knowledge To Assist Clients In Resolving The Wide-Range Of Challenges Facing Medical Practices Every Day.

Revenue Cycle Management