Understanding the Basics of RCM

While most people see Revenue Cycle Management as simply the billing and filing the claims of patient, that is not actually the whole picture. True, the whole revenue cycle management starts as soon as the patient steps inside a hospital or clinic.

However, not many may realize that it involves not only the doctors that the patient gets in touch with, or the first person that assists him or her. In fact, when trying to answer what is revenue cycle management, you will realize that involves everyone in the hospital including those who schedule the appointment.

The Basics of Revenue Cycle Management

The simplest way to define revenue cycle management, or RCM, is to liken it to the circulatory system, albeit, one that involves money instead of blood – its proper “circulation” ensures the life of a healthcare institution.

While the steps involved in an RCM may vary from one institution to the next, some of the common features would include scheduling and pre-registration, Encounter Utilization Review, charge capture and coding, submission of claims, remittance processing, and payment posting as well as receipt of appeals and collections.

Now, for an RCM to be run properly, an organization would need the use of various technologies. These software and applications can help track claims as well as ensure that payment has been made in a timely manner. You have to keep in mind that, with the wealth of information that needs to be processed on a daily basis, the technology that a hospital will use should be one that can easily integrate with each other.