Hospitals are multi-million dollar businesses that depend on revenue to survive. The success of the hospital relies heavily on the revenue cycle management team. Revenue Cycle Management is not just about billing and collecting money, it includes all aspects of processing information through the entire revenue cycle.
With more than 500 hospitals in America alone, this means there is a lot of competition for market share. Learning what you can about revenue cycle management prepares you for your future career.
Revenue Cycle Management (RCM) is one of the most important parts of any organization’s operations because it affects every department within an organization including finance, accounting, marketing, and many others. RCMs’ job isn’t limited to billing patients; hospitals, also process information that affects their distribution.
Predictive testing and inspection with checklists are an integral part of this process. Errors found here can serve as a delay in the claims process which affects accuracy and reimbursement rates.
Overpayments are processed to accounts payable where they’re recorded until the differences are resolved with medical records. These types of errors can cause problems if someone tries to pay with a credit card or if someone is accidentally charged twice.
The revenue cycle process should be seamless and transparent to the customer.
4 Things You Should Know About Revenue Cycle Management:
1. What It Is
Revenue cycle management is a collaborative effort between the hospital and the patient (or insurance company, or other payers). The Importance of RCM is that it communicates with both parties to ensure that everyone’s rights are satisfied. Also, it’s important for the hospital to get paid the correct amount while not over-charging patients. Over-charging can be just as detrimental to the hospital’s success as not getting paid at all.
2. What Is It Used For
Revenue cycle management is designed to protect patients’ privacy rights by ensuring that their protected health information (PHI) is secure at every point in the revenue cycle process. This information, if breached, could be used for identity theft. That means that information is secure from the time it leaves a patient’s medical record until it reaches an insurance company.
3. Tasks It Performs
There are many different parts of the revenue cycle, such as billing (claims), payment posting (collection), collections (patient responsibility), and clearinghouse operations (transmission and exchange), just to name a few. Also, performing and complying with audits are important tasks that are also part of the revenue cycle.
4. RCM As A Career Choice
Revenue cycle management is a challenging career that requires extensive training, knowledge, and other certifications. This process can take years to master, but it will all be worth it when you’re part of an efficient organization that takes pride in running properly. Revenue cycle management is often overseen by a revenue cycle management director, who oversees the entire process workflow.
Revenue Cycle Management is a critical process for any hospital. By understanding the importance of RCM and its functions, you are well on your way to a successful career in healthcare. Revenue cycle management protects patients’ privacy rights while ensuring that their PHI is secure. It also involves many different parts, such as billing, payment posting, collections, and more. Lastly, revenue cycle management is a challenging field that requires extensive training and knowledge.