Knowledge Center

Revenue Cycle Management (RCM)

 The revenue cycle begins when a patient is scheduled to see a physician for a visit and ends when payment for all services and treatment provided during the visit is received. Revenue Cycle Management (RCM) solution provides an end-to-end solution that enhances patient satisfaction and helps boost the bottom line. It automates processes and strategically unites patient data from one end of the revenue cycle to the other.

Today, practices very well understand the fact that failure to ensure that insurance payments are appropriate and accurate can negatively impact the total payment received as well as the amount the patient will ultimately pay. Revenue cycle management (RCM) eliminates many of the common issues that affect physician offices on a daily basis. Daily reconciliation is handled with a click of a button for office staff to monitor the flow of patients to payouts.

Revenue Cycle management (RCM) solutions reduce denials, improve net collections and increase productivity by:
  • Understanding current billing process of Practices and helping them in speedy transition of their practice from either an in-house or outsourced billing environment to Revenue Cycle Management (RCM) solution.
  • Performing real-time eligibility verification
  • Detecting claim errors before submission to payers
  • Medical coding, patient health information entry and management
  • Electronically generate and submit claims to Medicare, Medicaid and major commercial carriers as well as automated insurance verification, claim tracking and handling EOBs (Explanation of Benefits) via EDI (Electronic Data Interchange)
  • Accounts receivable follow-up
  • Review reasons for denials and corrective measures adopted for better revenue realization.
  • Monthly report analysis: Generating encounter bills, statements, and reports
  • Claims review, approval and denial along with insurance company relations management.

Revenue Cycle Management (RCM) handles day-to-day tasks of practices from creation of the receivable to its adjudication, payment posting, follow up, comprehensive reporting, and refund processing. Increased profits, streamlined operations and a strengthened financial position are all benefits of the right type of RCM implementation. It helps medical professionals to maximize their collections while eliminating the financial and human resource headaches.

Revenue Cycle Management (RCM) helps practices through all phases of their business, providing accountability, consistency, and most importantly, results. It helps medical professionals to maximize reimbursements and increase cash flow while providing valuable information to manage their practices and control costs.

From submission of a claim to posting payments, billing patient's balances and following up with insurance companies - Revenue Cycle Management (RCM) does it all, so that physicians can focus on their core expertise and spend more time on delivering the best care to their patients.

ClaimatTM: Claimat is an integrated healthcare connectivity application providing cost effective, self-sufficient and direct connectivity products and services for the healthcare industry. Claimat is an easy to use claims submission and management system.