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What Is Revenue Cycle Management in Medical Billing?

What Is Revenue Cycle Management in Medical Billing?

Did you know that medical insurance denials have risen by 11% in the past year? And that one out of four of those denials was due to problems with patient registration and insurance eligibility? 

If your medical practice has seen an uptick in denials, then you need to improve your revenue cycle management. Don’t worry if you’re asking, what is revenue cycle management in medical billing? You’re in the right place because we’ve created this beginner’s revenue cycle management guide just for you. 

What Is Medical Billing?

Medical billing connects the front office with the back office. This is where patient care translates into payment for services rendered. 

In addition, medical billing is unique in that your practice essentially has two payors. The patient usually has a small copay. And the insurance company will determine how much they will cover.

If there is a discrepancy in what the insurance covers, your medical practice could be left holding the bill. Your job is to ensure that your patients understand their responsibility while also ensuring that you submit the proper claims to their insurance. 

What Is Revenue Cycle Management? 

Revenue cycle management is the department that typically handles billing for any organization. The cycle refers to: 

  • Collecting patient information at registration
  • Communicating with patients about their financial responsibilities
  • Communicating with insurance payors
  • Collect payments from both payors and patients 

As you can see, RCM is vital to the financial health and stability of your medical practice. In the medical field, the revenue cycle can become complicated if your patients don’t understand their responsibilities.

In addition, as mentioned, insurance companies are increasing their denials. So your staff must stay up to date on the latest billing and coding practices. 

What Is Revenue Cycle Management in Medical Billing? 

The revenue cycle begins when a new patient calls to schedule an appointment and ends when you collect all payments. Whether you’re a small private practice, large hospital facility, or anything in between, RCM allows you remain fiscally stable and profitable. 

You can see why RCM is vital to the growth of your practice. Some key changes that many healthcare providers are making to keep up with changes include: 

  • Digitizing and automating their processes
  • Outsourcing their revenue cycle management
  • Maintaining ongoing education for their staff

These changes have allowed many practices, both large and small, to drastically reduce the costs associated with healthcare. You don’t have to struggle any longer; outsourcing and automation can help you collect payments in a timely manner. 

Improve Your RCM Today

This medical billing guide provides you with the basic information you need to ensure your practice has the tools you need to run your business. Now you can stop wondering, what is revenue cycle management in medical billing?

You’ve got the information you need to make the right decisions for your medical practice. For more great information on this and other topics, check out the rest of our blog. 

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