Healthcare organizations and hospitals are engaged in providing the healthcare services all the time. These services are crucial for treating, monitoring and assisting patient well-being. They take care of patient requirements from admitting, treating, scheduling appointments and providing specialized services.
Revenue cycle management is also known as RCM is the financial process that healthcare facilities utilize to track complete patient care from registration, appointment scheduling to the final payment with the help of customized medical billing software.
The Healthcare Financial Management Association (HFMA) defines a revenue cycle as "All administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue."
Role of Revenue Cycle Management Systems
Revenue cycle management plays a significant role in any clinical research.
It involves medical billing that is a form of communication between an insurance company and the care provider. The billing cycle is also termed as the revenue cycle management as it includes, elaborates and explains the entire medical billing phenomenon.
Today, healthcare systems make use of automated systems to manage the RCM or revenue cycle management processes and also to fill any gap of payment arising from the processes of medical billing and the collections. This is because the reason for employing an automated system is that IT processes like hospital information systems, and EHR are obsolete technology platforms that lack sophisticated. Healthcare facility's functionalities required to take care and of RCM issues. Healthcare facilities and hospitals mostly prefer to outsource these RCM services.
Global Healthcare Revenue Cycle Management (RCM) Software Market 2017-2021 report published in June-2017 by Infiniti Research forecasts’ the global Healthcare Revenue Cycle Management (RCM) Software market to grow at a CAGR of 4.50% during the period 2017-2021.
At present, and in future consumer demand for convenience and transparency is expanding. They want to know what they are being, charged, what their insurance is paying for and what they will have to shell out from their pockets. Consumers are seeking easy and convenient ways of making payments.
The six important healthcare revenue cycle management systems for 2017 are as follows.
- All scripts
- GE Healthcare
- Athena health
It is crucial for healthcare organizations and hospitals to opt for the best suitable RCM system. If the system is inefficient, it can incur huge losses for the healthcare organizations.
As Jon Neikirk.assistant vice president of revenue cycle for Milwaukee-based Froedtert & the Medical College of Wisconsin rightly says
“My advice would be to focus on the patient experience and make it the driving force behind projects you take on. Price transparency is our biggest one lately. The healthcare industry needs to move this topic to the front of conversations with patients. Let them know what to expect in a way that's meaningful to them. We recently started giving patients out-of-pocket cost estimates. I also would recommend keeping an eye on self-service technology — apps that let patients self-schedule and do other things. It's the way things are going in the future.”
To create a successful healthcare business that gives a boost to higher revenue performance in today's world and financial health, healthcare organizations require a robust revenue cycle management system that is super-efficient from beginning to end.
Tom Schaal, director of product management at healthcare analytics company MedeAnalytics rightly explains -
"Ultimately, the end goal in RCM is working smarter, not harder. Hospital staffs are routinely stretched thin. Intelligently designed analytical tools are geared towards highlighting opportunities and outliers, and focusing staff attention to the most impactful workflow and resolution strategies."