What is the Value of Revenue Cycle Management for Your Hospital?

medicaid claimsRunning a hospital is running a business. Yes, patient care is at the heart of every medical facility, but you also need to ensure sufficient funds to compensate the staff properly and provide excellent services for years to come.

One of the ways to do so is to implement a revenue cycle management system that works for your healthcare organization. This type of service allows your hospital to balance the medical and financial sides of the business.

What is Revenue Cycle Management?

Revenue cycle management, or RCM, is the process of tracking a patient’s financial and medical information. RCM marries the clinical and business aspects of healthcare by providing the hospital administration with complete and up-to-date data about their patients.

Recording accurate patient information is crucial when coordinating with the insurance provider; doctors and nurses need correct data to deliver the medical procedures that the insurance provider will cover.

What is Included in the RCM Process?

The RCM process involves various clinical and administrative functions, with each function streamlining data collection. Using RCM, a hospital can then have an easier time organizing the information and deploying it to relevant parties: the patient or the patient’s insurance provider.

Before anything, RCM starts with charge capture. Charge capture involves accurately assessing the billable charge for each medical service that your hospital offers. This feature gives both your patients and their insurance providers an exact amount to work with once the bill is ready for payment.

A reliable RCM system can assign codes for various procedures and diagnoses, making the organization process much more efficient.

After determining the charges for your services, the next step is to register the patient. This step involves collecting personal information prior to any inpatient or outpatient procedure. The information your hospital collects at this point should include the medical history, along with their insurance details.

Access to data gives your hospital an idea of how much the patient’s insurance can cover, allowing you to give your patient and the insurance provider an accurate estimate of their hospital stay. As a result, you prevent unexpected charges, which helps you to improve the hospital’s service.

Once the patient’s procedure is complete, an efficient RCM will then help with your claim submission. This step involves sending properly coded and filled-out billable fees to the patient’s insurance providers. As soon as the insurance provider receives the bill for the patient’s hospitalization, the RCM system then asks for a follow-up of payment from the insurer.

Serve Your Patients Better

Proper RCM, however, doesn’t end with fee settlement; an efficient RCM system will then review the entire process, from patient registration to payment, and find ways to economize it in the future. This might involve streamlining a step, or examining whether or not a particular procedure was necessary.

With the right RCM system, your hospital will find better, more efficient ways to serve your patients.

When it comes to finding a revenue cycle management service, DECO has the necessary tools that are efficient and effective, helping you economize your hospital systems. Our service enables your hospital staff, from administrators to doctors, focus on providing quality medical treatment instead of being bogged down by the entire revenue cycle process.

To learn more about our services, click here.

Pete Ash

Pete is the Vice President of Sales & Client Services at DECO Recovery Management. He covers the Mid Atlantic region and specializes in Medicaid related topics. It is DECO’s Mission to maximize reimbursement to our clients by leveraging innovative technology, processes and compassionate advocates to provide exemplary service.

Categories: Medicaid

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