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Revenue Cycle Management Service
Optimizing Financial Performance in Healthcare
Revenue cycle management (RCM) is the process of collecting revenue for healthcare services. When it comes to running a healthcare organization, revenue cycle management is critical because, without suitable and efficient execution, any healthcare entity’s survival is compromised. The purpose of this extensive guide is to inform users of the following aspects of RCM:. The importance of RCM, the process of adopting it, and the benefits of revenue cycle optimization with the help of TymMed Solutions, a well-known medical billing solutions provider.
What is Revenue Cycle Management?
Revenue Cycle Management (RCM) is the financial process, from registration and appointment scheduling to final payment of a balance, that healthcare providers use to track a patient’s care episode. RCM covers the clinical and administrative aspects of claims processing, payment, and revenue collection.
The Revenue Cycle Management Process:
Step 1: Patient Registration and Scheduling
The RCM process commences with the patient registration where collecting patient demographics and insurance details. This is needed in order to avoid essential information to make the following claim successful.
Step 2: Insurance Verification
Checking the primary and secondary insurance for a patient and ensuring eligibility and coverage is a critical task for correct billing as it minimizes the instances of claim denial.
Step 3: Medical Documentation and Coding
Patients expect a record of their appointments and treatment, as well as a bill that accurately detailed the services provided. Medical terms would need to be morphed into standardized codes representing diagnoses and operative procedures.
Step 4: Claim Submission
It is here that claims go off to the insurance companies for reimbursement. Bulk (ie, corresponding to one or multiple patients) claims go off to the insurance companies only if the above validations have been completed. Upon completion of validations, the claims are checked to see if they are complete, correct, and answer all the payer rules.
Step 5: Payment Posting
Money payments from insurance companies are posted to the patient’s ledger. Difference between billed amount and received payment is credited or debited.
Step 6: Denial Management
From there, they receive a denial, take the correct steps to rectify the issue, and resubmit the claim. The RCM team works with the recipient to research the reason for the claim denial and determine the needed correcting steps.
Step 7: Patient Billing and Collections
Patients are billed for the balance amount after insurance payment. Communication and follow-ups are the key for timely collection.
Benefits of Partnering with TymMed Solutions for RCM:
Increased Revenue: Maximize reimbursements with accurate coding and efficient claim processing.
Better Cash Flow: Improve cash flow with faster claim turnaround and lower denials.
Increased Efficiency: Give your staff more time to focus on patient care when time-consuming RCM tasks are outsourced.
Reduced Costs: Minimize administrative burdens and streamline your operations for improved cost-efficiency.
Partner with TymMed Solutions Today
while TymMed Solutions takes care of your Revenue Cycle Managment (RCM) requirements. Contact us today to discuss your specific needs and get started!