Revenue Cycle Management
Revenue Cycle Management encompasses the process of getting paid for healthcare services that are provided.
Information
The Revenue Cycle Management process begins when a patient schedules an appointment and it ends when the healthcare provider has accepted all payments.[1] Errors in Revenue Cycle Management can lead to the healthcare provider receiving delayed payments or no payment at all. Healthcare providers can turn over their Revenue Cycle Management to companies that handle this complex process 24/7.[2]
Medical billing is getting increasingly more complicated, especially as medical code guidelines are making the switch from ICD-9 to ICD-10. Proper Revenue Cycle Management ensures that billing errors are reduced so that reimbursements from the insurance companies are maximized. Revenue Cycle Management teams are responsible for maintaining compliance with coding regulations, such as the ICD-10 code update. Using the right coding for services rendered by a practice ensures that insurance claims can be processed and that the practitioner is compensated for all of their services rendered. A revenue cycle management team is able to handle this, rather than having the doctor take care of patients and learn new medical coding protocols.
Achieving Optimal Coding
Achieving optimal coding means you are complying with all coding regulations and coding for the highest allowable reimbursement. Insurance claims must be accurate to avoid delays in reimbursements or denials. By achieving optimal coding, a medical practice is able to run efficiently and smoothly from the time a patient makes an appointment to after all payments are processed.
References
- ↑ "Revenue Cycle | Patient Business Services | OHSU". Ohsu.edu. 2013-04-16. Retrieved 2015-08-26.
- ↑ "Show Me the Money... A Look at the Revenue Cycle from the Billing Perspective". Library.ahima.org. Retrieved 2015-08-26.