The Impact of Healthcare Revenue Cycle Management Solutions
Healthcare in the United States is a meandering labyrinth of regulations and red tape. This bureaucracy is perhaps the main reason why it is the most expensive healthcare system in the world, with a highly complex revenue cycle process.
After a patient’s clinical visit, the medical services are documented and coded so that claims can be filled out and sent to payers. After an insurance payer receives a claim, they process it to check if everything is done alright and then reimburse the provider for his or her services. Unsurprisingly, this procedure could take a few days and if there’s something wrong with the claim, there are delays that might stretch for weeks. It’s because of these issues that revenue cycle management becomes an absolute necessity.
Revenue cycle management or RCM in healthcare in the United States involves all the activities carried out by organizations in healthcare to track the revenues from the patients. Needless to point out, RCM healthcare in the USA has become integral to the industry. A steady healthcare revenue cycle depends upon the success and efficiency of a number of workflows that need to be done after each patient visit. From verifying patients’ insurance plans to documenting the visit, coding it, sending the claims across to the payers, and tracking the claims, it’s no doubt that the medical revenue cycle process is highly bureaucratic and prone to errors.
Revenue cycle management software solutions make up a sizeable chunk of the market for medical technology. As the name suggests, such platforms streamline the entire workflow around revenue cycle management and bring about improved efficiency and productivity. The activities that would have needed to be done manually can be carried out using a digital interface. Let’s look at some ways a revenue cycle management system -
Patient Management
Managing a patient’s entire care journey at a hospital is no small feat. Tracking his or her vitals, ordering tests and scans, retrieving the results, documentation, billing, and coding, followed by claims to a payer are the activities that go into patient management. All of these ultimately are connected to medical billing and so must also be integrated with revenue management cycle activities. That is where healthcare revenue cycle software can help streamline all activities to simplify the workflows around patient management.
In targeting patient management, the RCM medical output is bound to experience a positive impact. Additionally, as there is going to be a single interface to manage patients, it would also optimize the clinical operations centered around patient care. The result is improved patient experience, coupled with better revenues.
RCM Reporting
As mentioned above, RCM (revenue cycle management) is complex. That is why it is important for relevant healthcare revenue cycle management software or any revenue cycle management system to have a reporting feature. Detailed reports on all activities reveal valuable insights into the entire process-chain surrounding RCM solutions. It shows all the pain points that cause losses, which enables administrators to take corrective measures. Some of those pain points include coding errors, bad patient engagement, errors in insurance verification, payer-specific reasons for denials and rejections, and so on.
This knowledge sheds light on what needs to be improved and how. In other words, reporting in revenue cycle management systems is key for streamlining medical administration.
