What is the Goal of Revenue Cycle Management?

All healthcare practices are focused on the same thing: achieving the best possible outcomes for their patients. It also requires paying attention to the business side of the healthcare practice–after all, if your practice is routinely running into cash flow issues and struggling to get paid on time, it’s going to be that much harder to accomplish your goals without a strong revenue cycle management system.

For this reason, smart healthcare practices are always focused on optimizing their revenue cycle, encompassing all of the clinical and administrative tasks and touch points that determine how much and when your practice gets paid for the services patients have received.

They do this through a process called revenue cycle management (RCM).

What Is Revenue Cycle Management?

As the name suggests, revenue cycle management is the process of managing the revenue cycle to ensure that cash flow remains steady. When healthcare practices are able to master the process, their financial situation improves considerably and it becomes easier for them to deliver top-notch care.

More and more practices are using RCM to improve their financial well-being. The result is a booming market: revenue cycle management market reached $105.18 billion in 2020 and is expected to grow to over $249.44 billion by 2028.

What Are the Benefits of Revenue Cycle Management?

At a very high level, revenue cycle management is all about improving a practice’s overall financial well-being. By making RCM a top priority, practices can improve the number of claims paid upon first submission, increase revenue margins, reduce denial rates, and generally accelerate payments.

RCM gives practices the peace of mind that comes from knowing they have correct patient information in the system at all times, causing your staff less stress. With less paperwork to fill out and more money on hand to finance your healthcare practice, quality of care improves and patients experience better health outcomes. 

How to Improve Revenue Cycle Management

Unfortunately, you can’t just decide to improve RCM, snap your fingers, and expect great results. With the right approach, however, you can make your practice’s RCM capabilities the envy of your peers. Here are four ways to make that happen.

1. Get the team on board

First things first: your RCM efforts won’t succeed unless you get your team on board. As you begin overhauling your revenue cycle policies and procedures, you need to take some time to educate your employees about why this is important. Once everyone understands the critical role that RCM plays in the health of the practice—and, by extension, their job security—it will be that much easier for them to take this area seriously.

2. Invest in the right tools

If your organization is still relying on paper-based workflows and manual processes, there’s no way your RCM results are as good as they could be. Not only does it take longer to submit claims to insurance companies when you’re doing things by hand, but you’re also more likely to have coding errors and other inaccuracies that slow payments down or cause claims to be denied. Since one recent study revealed that as many as 90 percent of claim denials are avoidable when you invest in the right solutions, upgrading your practice’s digital capabilities here is a no-brainer.

3. Automate prior-authorizations

When patients come to your practice and they aren’t covered for services, it takes that much longer for you to get paid—assuming you get paid at all. By using technology to automate the prior-authorization process, you can ensure that patients have coverage before you deliver services, and that services aren’t given to those who have no coverage.

4. Consider outsourcing RCM altogether

Instead of investing in RCM tools and administering the process in-house, you might be better off partnering with an RCM services provider and letting them handle everything on your behalf. By doing so, you can rest comfortably knowing that a seasoned and experienced vendor is taking care of this critical function for you. You can also work together to determine which areas of your processes can be improved, supercharging your practice’s cash flow and speeding up the revenue cycle.
If you’re looking to improve your practice’s financial situation, CollaborateMD can help. To learn how we can help you improve your revenue stream, check out our revenue calculator.



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