Understanding the Revenue Cycle from A Billing Perspective

In the past, the idea of revenue cycle can raise eyebrows and strange looks from doctors and hospitals administrators. After all, why would there be a need for a management system when there is already the billing section and the revenue section? Today, however, it’s a different story what with RCM being a tool that allows company to ensure timely payment and increased revenue from patients and third-parties.

Having and implementing a revenue cycle management system, however, is not as easy as it looks. At the very least, in order for it to be successful, you would need to have open lines of communication with your staff, the right training for your encoders, and the full support of the doctors and hospital administrators. Keep in mind that, with RCM, the revenue point starts by the time the patient steps into your hospital.

Running a revenue cycle system would mean documenting not only every process but also making sure that these documents are correct and accurate. The documentation process does not also end with putting the required procedures in black and white. In fact, you also need to make sure that your patients have the proper documents with you and that their information are properly coded.

Keep in mind that revenue cycles not only allow a hospital to control their billing and collection system but also ensures that security checks are in place to scrutinize for eligibility for, say, benefits under the social security disability for children program. If the encoded information are incorrect, claims for reimbursement might get denied.