Revenue Cycle Management (RCM) is the process through which healthcare providers and hospitals collect patient bill payments from insurance companies. Revenue Cycle Management (RCM) has thus become one of the most important areas of hospital and medical billing companies. Furthermore, it is a complex and time-consuming process, which is why medical bill payments are outsourced to expert companies.
How does the RCM function? As discussed above, the process is complex and may involve several phases. Despite the fact that these phases differ from firm to firm, the majority of revenue cycle management firms follow the same procedure.
Prior to receiving treatment, the patient must first schedule an appointment with his healthcare provider. During their appointment, the patient may inquire whether his medical insurance will cover the treatment.
The practitioner will check whether the patient’s treatment will be covered by his insurance plan at the patient’s request.
After the patient has received the treatment, a comprehensive report based on their medical history, illness, and treatment is produced. The medical biller receives the report and prepares the claim based on it. The claim must also be submitted electronically, as all medical claims must. The medical biller checks whether the claim adheres to billing standards as a result.
Claimant will verify how much amount can be utilized in the next step. A statement is prepared by the claimant, and the patient then collects the payable balance.
The process of working with an RCM company is a great way to see how it all works. Here is what you should look for in the top revenue cycle management firms:
The Company’s Experience:
When seeking a corporation with superior revenue cycle management technology, you should always compare the ages of various firms. The older the company, the more dependable it will be. At least the company should have been in operation for five years to be able to compete with other firms in the industry.
ISO 9001 Certification:
Checking for ISO 9001 certification is another common yet effective way to narrow down the options. The ISO 9001 certification ensures that a particular process meets desired quality standards.
The RCM Company’s Clients:
When selecting a revenue cycle management firm, checking their client list is one of the mainstream criteria. The quantity and variety of clients the company serves are important in selecting a dependable and experienced RCM firm.
HIPAA sets standards for protecting the privacy of individually identifiable health information.
It is crucial to the patient’s perspective that you verify the HIPAA compliance of RCM companies. HIPAA sets standards to ensure the protection of the patient’s personal data.
When searching for a top revenue cycle management firm, consider the aforementioned factors.