A Guide to Revenue Cycle Management in Healthcare

FREMONT, CA: In the world of healthcare, revenue cycle management (RCM) is a critical process that involves managing the financial aspects of patient care. It encompasses the entire patient journey, from scheduling an appointment to billing and receiving payment. Effective RCM is essential for the financial health of healthcare organisations, as it ensures they receive timely and accurate payments for their services.

The core concepts of revenue cycle management in healthcare include -

• Patient Registration

The first step in the revenue cycle management process is patient registration. This involves capturing the patient’s demographic and insurance information, as well as obtaining their consent to receive treatment. Accurate and complete patient registration is critical, as it ensures that the correct patient information is used throughout the revenue cycle.

• Appointment Scheduling

The next step in the revenue cycle management process is appointment scheduling. This involves scheduling the patient’s appointment and verifying their insurance coverage. It is important to verify insurance coverage before the patient’s visit to ensure that the organisation is reimbursed appropriately.

• Charge Capture

This is the process of capturing the charges associated with the patient’s visit. This includes charges for services such as office visits, lab tests, and procedures. It is essential to accurately capture charges, as it ensures that the organisation is reimbursed appropriately for the services provided.