What is RCM Healthcare?
Revenue Cycle Management is a critical part of a healthcare system as it helps medical facilities and clinics manage billing episodes. Using billing software, healthcare facilities track patient’s visits until the final payment. Nowadays, it’s not unusual for medical clinics and hospitals to outsource RCM, which helps medical facilities to concentrate on providing medical services.
In simple words, RCM combines the business and clinical sides of the healthcare business. As medical professionals provide medical services, RCM is used to store information regarding the type of treatment the patient receives, which is then decoded to provide relevant information to insurance companies and other stakeholders.
The key component of the RCM in the healthcare system is communicating with the health insurance provider. In a traditional setup, the hospital staff checks the patient’s insurance history before scheduling an appointment. After the treatment, the insurance company is notified of any billing claim while the remaining payment bill is sent to the patient.
RCM is critical to decipher and code patient’s information according to ICD-10 codes. The standardized coding system allows doctors, administrators, insurance providers, and other stakeholders to view the patient’s data, treatment history, and medical costs in a uniform and consistent pattern.
What is Involved in RCM?
A revenue cycle administered by RCM system usually includes the following:
• Capturing medical charges and decoding them for doctors, insurance providers, and stakeholders.
• Registering a patient’s information before and after the appointment to establish a medical record number to meet various legal, financial, and clinical requirements.
• Recording the patient’s bill and balances at every stage of the treatment cycle.
• Processing remittance by accepting and rejecting medical billing claims and remittance.
• Collecting payment from third-party insurers and other stakeholders.
If you require the assistance of a company to administer your RCM, please visit GeBBS Healthcare Solutions.