what is revenue cycle management in healthcare

what is revenue cycle management in healthcare

1 year ago 89
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Healthcare revenue cycle management is the process of managing the administrative and clinical functions associated with claims processing, payment, and revenue generation in healthcare facilities. The revenue cycle begins when a patient makes an appointment to seek medical services and ends when organizations have collected all claims and patient payments. The process consists of identifying, managing, and collecting patient service revenue. The revenue cycle can be viewed in three different phases: Order to Intake, Care to Claim, and Claim to Payment. There are 17 unique steps in the revenue cycle, which include charge capture, claim submission, coding, patient collections, and preregistration. The goal of revenue cycle management is to identify any points of friction in the provider’s revenue cycle and resolve them, so care providers can maximize their claim reimbursements and increase their patient service revenue. Effective revenue cycle management enables healthcare providers to improve cash flow and profitability, allowing hospitals to expand and evolve their services to patients.

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