helen rai
Revenue Cycle Management (RCM) is an essential process in the healthcare sector that oversees the financial elements of patient care, spanning from the first appointment to the ultimate payment. This process encompasses various critical components and offers numerous advantages
Key Elements of Revenue Cycle Management
Pre-Registration: It involves the collection of patient data and insurance information prior to the scheduled appointment.
Eligibility Verification is the process of confirming insurance coverage and benefits to ascertain which services are included.
Charge Capture focuses on the precise documentation and coding of services delivered during the patient visit. Claim Submission refers to the act of transmitting claims to insurance providers for reimbursement purposes.
Claim Submission refers to the act of transmitting claims to insurance providers for reimbursement purposes.
Payment Posting includes the recording of payments received from both patients and insurers, along with the reconciliation of accounts.
Accounts Receivable Management is the follow-up on outstanding claims and patient balances to facilitate prompt payments.
Denial Management involves the identification and resolution of claim denials to recover potential revenue losses.
Reporting and Analytics consist of the examination of financial data to uncover trends, enhance processes, and improve overall financial performance.
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