Medical Revenue Cycle Management

Revenue Cycle Management

Revenue Cycle Management is a key part of managing the business side of a medical practice. The best medical practices, clinics and hospitals have mastered merging the clinical and business functions. RCM goes far beyond simply managing billing. RCM enables you to see where your money is going. From top level views to line-item details you can get the information that enables you to better manage your business.

What is the Medical Revenue Cycle

The Healthcare Financial Management Association (HFMA)
defines revenue cycle as "All administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue."
Effectively this means the revenue cycle encompasses all revenue related components of a patient’s account.

What is Revenue Cycle Management?

Revenue Cycle Management (RCM) refers to the financial management of your practice relative to income from services. Leveraging the power of medical billing software your practice can manage all aspects of the process. As the name implies, revenue cycle management is the process for managing every step of the revenue generation and collections process.

The Importance of Revenue Cycle Management in Healthcare

Improving your RCM process almost certainly improves your bottom line. RCM management tools for healthcare are included in the top revenue cycle management software. The beauty of a robust RCM software is it enables you to manage all financial aspects of account management. Lytec is a leading revenue cycle management software companies with support in the United States. Relative to improving your revenue management Lytec’s medical billing software empowers your staff to:

  • View and manage patient personal and financial data
  • Scheduling management
  • Easily assign proper ICD-10 billing codes
  • Transport claims to credentialed payors
  • Track and assign payments to patient accounts
  • Query and run reports

RCM Improves the Patient Experience

RCM also provides benefits to patients. Through better management of claims processing the amount of denied payments is reduced, thereby lowering a patient’s out-of-pocket expenses.

Ways to Improve Your Revenue Cycle

  • Develop a patient registration process that confirms eligibility and coverage. Taking time up-front to make certain that you have complete and accurate information is a critical success factor.
  • Leverage pre-admission contacts as appointment reminders and to confirm coverage information. This can reduce the occurrence of missed appointments, and discovering post service that the patient cannot pay in a timely manner.
  • Develop a claims quality checklist that includes reminders on the unique requirements of each provider. This minimizes the odds of claims denials for reasons such as incomplete information, missing documentation, and patient ineligibility, etc.
  • Be vigilant in maintaining a good understanding of major payors regarding what is or is not covered. The terms of provider contracts can have a profound impact on your business.
  • Pursue creative ways to expedite the payment process. An often-overlooked opportunity is getting payors to remit electronically. This can shorten the payment cycle by weeks.

Medical Revenue Cycle Management

The Benefit – Get Paid Faster, Improve Your Bottom Line

Obviously, communicating with insurance companies is a critical part of the revenue management process. Being able to quickly submit a billing statement means getting paid as soon as possible. Your medical billing software allows you to quickly prepare and submit payment requests. The ability to view current receivables reports supports timely follow-up and collections efforts.

The best medical practice software includes appointment scheduling capabilities. Using the email functionality, you can send timely appointment reminders. Reducing the number of missed appointments contributes to improving daily revenue.

This same functionality can be used to email payment reminders. This is helpful in surviving problems with the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)

HELPFUL TIP: For ongoing process RCM process improvements you should note reasons claims have been denied. There are often things that you can teach your billing personnel such as timely filing. This should include the unique requirements and preferences of individual insurance companies. This can prevent the re-occurrence of common billing errors, which improves your A/R aging trend.

In Summary

Utilizing revenue cycle management can provide an opportunity to improve the patient experience, patient care, and your operating efficiency. Lytec’s revenue cycle management software provides the tools needed to implement and manage a successful RCM process. We invite you to give us a call to learn more about revenue cycle management.