For healthcare providers who want to get paid for the work they do, understanding the way that revenue flows from patient to provider is critical. Essentially, this is what revenue cycle management is: the journey from patient registration to receipt of payment.
This process involves coding, filing, and tracking claims. The goal is to make sure you receive the revenue you earned for the care you provide. Sounds straightforward, right?
Well, as a healthcare provider, you likely already know that it can be anything but.
What Does RCM Stand for in Healthcare?
RCM stands for revenue cycle management. In this blog, we’ll use RCM and revenue cycle management interchangeably.
What Are the Steps in the Revenue Management Cycle?
RCM starts long before claim submission. The process begins when your patient schedules their appointment or arrives at your practice and fills out their registration. Accuracy in this step (and each subsequent step) is crucial for ensuring that you are adequately compensated for your services.
While the specific process can vary depending on the claim type, here’s a general overview of the steps of RCM:
- Patient registration: The goal of this step is to capture accurate patient information that will continue to be used throughout the process.
- Eligibility and benefits verification: Confirming the patient’s insurance coverage and benefits.
- Coding and claim submission: Documenting services provided, applying appropriate medical codes, and submitting claims to insurance companies.
- Denial management: Ideally, your claim would be accepted and processed on the first try. This is rarely the case, however, which is why denial management is such a big challenge for many providers.
- Patient billing and collections: Issuing invoices to patients for any remaining balances and managing collections.
Why Should You Partner with an RCM Specialist?
You likely entered the healthcare industry to help people, not to chase complex claims through a labyrinthine process. When you have lingering RCM issues that prevent you from accessing the revenue you’ve earned, it’s a distraction from what you entered this field to do: provide exceptional patient care.
The advantages of partnering with an RCM specialist like EnableComp are clear:
- Accurate, on time, and ready for anything: Specialists have a deep understanding of the RCM process, ensuring you get paid correctly and on time. But RCM can be a bumpy road. We’ve seen it all and done it all, and our clients trust us to be ready for anything. No matter the source of the problem, we have a system in place, and we can help you pivot and adapt.
- Reduced stress and frustration: Automated tools allow you to submit claims with maximized efficiency and minimized compliance risk. Built by tech innovators, complex revenue cycle-management experts, and supercharged by human-in-the-loop interaction, our powerful platform streamlines and optimizes your complex claims. After decades of refinement and millions of dollars of ongoing investment, it just keeps getting better.
- Improved financial health: Expert RCM services can lead to better financial outcomes for your practice. With over $5 billion in found revenue, our clients see an average of 20% uplift to cash collections and a 43-day decrease in pay.
- Focus on patient care: When you outsource your specialty RCM to EnableComp, it allows you to stay focused on your primary mission — providing high-quality patient care.
Call Us Today to Schedule a Free Consultation
For many healthcare providers, RCM feels like a never-ending game of catch-up, a cycle of ensuring payments are received without a solid system in place to guarantee you’re compensated fairly and promptly. At EnableComp, we believe that healthcare providers deserve to get paid for the work they do. That’s why we help providers from across the country find more revenue and greater control by leveraging our team of experts and proprietary technology to streamline the complex claims process and recover money others leave behind. It’s your revenue. We’ll find it.
Ready to find out how our specialty revenue cycle management platform can help you? Schedule a free consultation today.
