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What is Healthcare Revenue Cycle Management?

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Revenue Cycle Management is business

Healthcare Revenue Cycle Management is the business aspect behind the administrative and clinical functions done by a physician. The financial process includes claims processing, payment and revenue generation. There are many steps involved in the above process, which are done by both the front and back offices.

An efficient healthcare revenue cycle results in smooth cash flow for providers.

Fundamental steps in RCM – the first part

RCM begins when a patient makes his/her appointment to visit a physician. And it ends when all payments due to the physician for services rendered are collected from payors and patients. The process from start to finish is rather complicated.

When a patient makes his/her appointment, the front office staff will schedule the visit, collect patient demographic information and thoroughly conduct insurance eligibility verification. Next a patient account is created with a medical history and all relevant information. This is a crucial step, as mistakes made here can result in claims rejections.

Fundamental steps in RCM – the mid part

Once the patient visit is over, the process of electronic claims submission starts. The patient’s treatment is now assigned standardized codes and the coding has to be done accurately. Then the amount to be reimbursed by the payor is entered in the form. Other details are entered into the claims form. The completed claims document is then sent to the payor electronically for reimbursement.

Fundamental steps in RCM – the last part

After the payor makes the payment, payment posting, statement preparation, collections and denial management have to be handled.

If the reimbursement does not cover the entire cost of treatment, the balance (co-pay) must be collected from the patient.

Claims can be denied or rejected on account of errors in the claims document. These have to be resolved and claims resubmitted.

So the goal of the entire medical revenue cycle management is to ensure that the healthcare providers are reimbursed fully and quickly.

How does Bristol Healthcare handle RCM?

  • We have invested in the latest technology for use in all our processes. Thereby work is done faster and there is less scope for errors. Also, our team is trained to work with many Electronic Health Record software. Hence a client does not need to change software when partnering with us.
  • Our billing team is in constant touch with patients and payors. Further, we educate the patient about their insurance coverage and how much they may have to pay as out-of-pocket expenses to the provider. We are in regular contact with payors to follow up on our claims.
  • Training is a vital component of our workflow. Our billers have their knowledge updated continuously as there is a constant change in the industry’s rules and regulations. They are dedicated personnel who value quality output.
  • We have a regular internal audit of our processes to improve our workflow and weed out possible error areas. Such monitoring of work to raise our service standards is the key that has sustained us all along.
  • Our medical billing company has handled all the revenue cycle steps successfully for thousands of clients over the years.
  • Whether it be revenue cycle management for small practices or bigger facilities, we can help you with our time-tested efficient services to maximize your revenue.

Benefits of partnering with Bristol Healthcare

We can guarantee the following benefits, to name a few, when you partner with Bristol Healthcare Services:

  • The superior quality of service
  • Lesser turnaround time
  • Cost-effective pricing
  • Dedicated account management
  • Minimum rejections
  • Uninterrupted cash flow
  • Effective processes
  • Use of latest technology

The coding and billing team at Bristol Healthcare Services ensures that the entire revenue cycle is smooth, efficient and result-oriented for our clients.

Reach out to us to see how we can be of assistance to you!

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