7 Crucial Stages of a Medical Revenue Cycle Management- How Does it Work?

Revenue cycle management is the most important factor of running a successful medical practice. With a successful medical revenue cycle management, healthcare providers are ensured that they are accurately reimbursed for their services. However, there are unparalleled challenges like complex billing structure, operating cost etc which may impact your revenue cycle. 

To ensure that the revenue cycle management for your healthcare organization is efficient and streamlined, you need to know about the seven crucial stages of a medical revenue cycle management to prevent revenue loss. 

Well, medical revenue cycle management in healthcare can be defined as tracking revenue from patients and the cycle starts right from the appointment and ends when doctors or hospitals are paid for the healthcare services rendered. 

This blog tells about the important stages of a medical revenue cycle management that will help you to be ahead of your competitors. 

Preregistration

This is the first step in the medical revenue cycle management process. During preregistration, healthcare providers provide a brief payment structure to the patients so that the patients can know their financial expectations. It also includes information about payment and cancellation policy. Having a firm

pre-registration process for a healthcare organization is paramount as there are several important areas of work which cannot get missed. 

Registration

The stage of registration in a revenue cycle management includes documentation or recording patients’ information such as address, phone number, date of birth, insurance information, and all the other necessary data accurately. Making sure that all the patient data are correct from start to finish is very important to bring in more revenue on time for any healthcare organization. During registration, financial forms are also signed and the insurance benefits are assigned. 

Capturing of Services

The charge capture process is one of the important phases of the RCM cycle in medical billing. This is the process of efficiently recording and submitting data about patient interactions to payers and insurance companies. Therefore, charge capture ensures that hospitals or healthcare providers get fully compensated for the services provided. If services are not correctly captured for billing, it may not get covered by the payer and lead to delayed reimbursements and even revenue loss.  

Claim Submission

This process in a medical revenue cycle management includes sending claims to the insurance companies so that all dues can be cleared on time without any delays. Well, it is always advisable to review and verify claim details before submission to reduce the likelihood of denial. Hence, reaching out to a RCM service provider will automate your claim verification process and ensure submission of error-free claims. 

Remittance Processing

In the remittance process of a revenue cycle management in medical billing, providers receive explanations of benefits which entails how much they got paid for the services provided. Providers should review the remittance to correct any errors if it’s there. Another important element of remittance includes identifying avoidable write-offs and preventing it with a detailed look at the reports. With experts’ guidance in the remittances management, your practice will have the professional guidance and tools to help you maximize your profits. 

Insurance Follow-up

The sixth step in the revenue cycle management process is taking insurance follow-up. This process allows providers to identify what they have been paid for and also if there is anything they have not been paid for. The most common issues can be denials, underpayments, and non-payments. If providers aren’t satisfied with the reimbursement, they will ask their team to take a follow up from the insurance companies and ensure the rates are adjusted in the upcoming set of payer negotiations. 

Patient Collections

It is considered to be one of the most complex parts of the revenue cycle management process in medical billing. This process involves calculating patient balances and preparing accurate patient statements. In this step, outstanding accounts are carefully monitored and are followed-up to ensure your revenue cycle is on track and your cash flow gets accelerated.

So, begin with a strong revenue cycle management  by enhancing these processes with expert help from Capline Healthcare Management. Connect with us today.