Revenue Cycle Management’s Importance in Healthcare

The Healthcare industry transition from fee-for-service to value-based care reimbursement impacts the traditional RCM (Revenue Cycle Management) in different ways. Every healthcare organization or an individual veteran practitioner needs to be financially balanced or strong to deliver their uninterrupted services. This is a time where best healthcare RCM service comes in.

Revenue Cycle Management in healthcare is the financial process that facilitates the control of complex administrative processes and clinical functions such as patient eligibility, claims processing, reimbursement, denied claims management, and revenue generation.

RCM is the backbone of healthcare organizations that helps them to pay their bills, manage their resources and much more. According to international standards report, in medical billing, more than 25% of claims have been rejected and up to 40% of those claims are never re-submitted i.e. the healthcare organizations suffer from major revenue loss.

On the bright side, with proper RCM process, the healthcare sector can get greatest benefits with minimum bad debt write-offs. To understand the exact phenomenon of healthcare revenue cycle management, first, you have to understand its basics in the medical billing process.

Basics of Healthcare RCM:

It starts from the appointment of a patient to seek any medical assistance and completes when the health organizations collect their payments.
At the beginning, the health group administrative staff manage an array of processes like scheduling, insurance eligibility verification and creation of patient’s account.
“From the perspective of Revenue Cycle Management, immaculate submission of patient information at the time of patient scheduling and registration improve the cash flow of the healthcare organization.”
After the patient’s treatment, the process of claims submission begins. An advanced coder submits the claims with right ICD-10 codes, the codes define the value of reimbursement and an approved code prevent claims denials.
Then comes the important part of private or government payer for payment. They evaluate the claim values, verify the details i.e. insurance coverage, contracts, etc. and process for reimbursement.
Most claims are denied due to improper coding, incomplete patient accounts, patient chart errors, etc.
Then comes the last outcome of revenue cycle management i.e. maximum claims reimbursement. RCM helps the healthcare organizations to get paid maximum claims reimbursement on time with fewer denials.
After that, the healthcare groups or the individual veterans perform the AR Follow up in which they create Healthcare claims i.e. manually or automatically and sends them to various Insurance companies.
In the final stage i.e. Payment Posting, the medical billing management software records every patient’s payment with accurate information including patient’s name, account number, denial info, service dates, etc. for future reference.
Importance in Healthcare:

It can help the healthcare organizations to track the exact performance of their financial growth. They can easily determine the claims approval and denial rates via proper RCM process. With immaculate RCM process, the healthcare organizations managed their medical billing process effectively and fixed their claim denial issues quickly.

Here are some key benefits of effective RCM:

Fewer denied claims
Improved patient care
Higher Reimbursements
Immaculate administrative records i.e. no other penalties or fees
Faster Turnaround time for claims payments
Deepak Yadav writes for Bikham Information Technology – a KPO firm that provides services in healthcare, finance and accounting and IT support sector. Its services include medical billing, bookkeeping, and much more. For more info visit our website Bikham Information Technology.

Healthcare Data Analytics and Importance

A systematic type of data analysis that makes it convenient for healthcare professionals to figure out possibilities of advancement in the healthcare system management, the process of diagnosis, and the engagement of patients are collectively known as healthcare data analytics. This involves the use of real-time & historical types of data analysis for predicting trends and gaining better insight into details of the information in the records. Several medical coding courses can help you to enter into this field.

Healthcare is an essential and ever-growing sector. Nevertheless, it is most important when it comes to treating the lives of living beings. It is not possible to handle such a large number of people at the same time. Through the implementation of data analysis in healthcare, many possibilities can be achieved that have never been seen before. Personalized medicines for certain diseases can be developed through analysis of the trends and patterns seen in healthcare. Several things can be seen in a genome, which otherwise cannot be studied by going into detail, but through the utilization of data analysis in healthcare, most of the patterns and trends can be unraveled with ease. A lot of advancement can be made possible in healthcare through the implementation of healthcare data analysis.

What are the benefits of Healthcare Data Analytics?

By utilizing healthcare data analytics, we can better understand patterns in various diseases and how they can affect various people. Based on these patterns and information, cures can be developed and better medication can be created for the patients.
Through healthcare data analytics, the rate of discharges can be understood as well as admissions for the patients and then analyzed better for staff efficiency. They can find ways to increase their own productivity while at the same managing multiple patients in a large number at the same time. By analyzing the data, the operational costs can be cut down and better healthcare opportunities can be available for the patients in need of it.
Since computerized records regarding the health of the patients can be analyzed, they can better collect the clinical data, diagnostic data, and other information related to any tests performed by the doctors, in turn helping the doctors to take better care of the patients’ healthcare.
It can provide great insight into disclosing the correlations between things. We can detect trends and patterns that were hidden before through which we can come up with effective medicine for a certain cause. Not all medications work for everyone. There are a lot of things to be studied in a genome. Through the use of healthcare data analysis, it is possible to find new trends that were first hidden and then correlate them and work towards forming a personalized medicine or treatment for a particular disease.
By analyzing the program as well as patient costs, predictions can be made for what will happen to the patients inside and outside of care. In the same way, through healthcare data analysis, there can be a reduction in the number of medication errors and therefore, work towards the betterment of the administrative healthcare performance.