Essay On Revenue Cycle Management

Revenue Cycle Management

There are many moving parts required to keep any type of healthcare facility running smoothly. Of these, the revenue management process is one of the most important. This is the patient to cash flow within the facility. The process begins when a patient schedules an appointment and ends when all outstanding payments have been collected. While it may seem simple, there is a lot that goes into the process as a whole, and it is a critical aspect of a facility being successful. Let’s start at the beginning and go through the process step-by-step.

• Step 1 – Scheduling an appointment: When a patient schedules an appointment, this begins the revenue cycle management process.

• Step 2 – Insurance certification: It’s

There are revenue cycle management systems available for healthcare facilities to use that makes this process much more seamless. These systems store and manage patient’s billing records. They are designed to work alongside other systems, such as a billing system or EHR, which allows for faster reimbursement. These systems are also able to conduct some tasks that are otherwise completed by a staff member. For example, sending out appointment reminders or notifying payers and patients of unpaid balances on an account. Revenue cycle management systems also cut down the amount of denials a facility has. The system will make sure all the required information has been entered to file a claim. If something is missing, the system will alert the user that further information is needed. Not only do these systems cut down on denials, they in turn save time for the staff members. Catching an error prior to submitting a claim eliminates the need to do the same thing twice to fix it. While these systems are wonderful, they are not all created equal. It is important that a facility chooses a system that best fits it’s needs. In years past, everything was completed on paper, submitted by mail, and paid by mail. Valuable time was spent waiting. With all the advancements in technology, facilities are now able to do everything electronically, which saves time and money.

As mentioned, analyzing the revenue cycle on a regular basis will highlight areas that need improvement. Tracking claims that have been submitted, as well as denials, will keep the process moving at a proper speed. Ensuring patients know the policy regarding their responsibility for payment is another way to impact the cycle in a positive way. If the facility requires payment at the time the services are rendered, it is vital to have those payments collected before the patient leaves the office. If the patient is unable to pay the full amount, payment arrangements should be discussed. Submitting an electronic eligibility request to the patient’s insurance company prior to their appointment is also helpful. This will let the patient know what they will be responsible to pay, after insurance, and includes any co-pay if it is due. Eliminating the possibility of a surprise bill will provide a quicker payment. The process of managing the revenue cycle is complex, but effective. As long as staff members know what role they play, and how to fill that role effectively, there should be few issues to