What is Healthcare RCM?

Revenue cycle management (RCM) is the backbone of the healthcare industry. It manages the providers’ finances and keeps them going daily—several organizations involved in the process to make it a success. The role of medical billing services in the US and the front-desk staff is undeniable.

Without this key financial process, healthcare organizations cannot keep their doors open to treat patients. Healthcare revenue cycle management is the strategy that healthcare organizations use to pay the bills.

Through the next sections, we will explore the basics of healthcare revenue cycle management and how it impacts the healthcare industry.

What are the basics of healthcare revenue cycle management?

Healthcare revenue cycle management begins when a patient makes his or her appointment to seek medical services and ends when all claims and patient payments have been collected. However, the life of a patient’s account is not as straightforward as it seems. To start, when a patient arranges an appointment, administrative staff must handle the scheduling, insurance eligibility verification, and patient account establishment.

What are some of the challenges with healthcare revenue cycle management?

With ever-changing healthcare regulations and new reimbursement models, it can be difficult for healthcare organizations to maintain stable healthcare revenue cycle management policies.

One of the top revenue cycle management challenges for healthcare organizations is collecting payments from patients at or before point-of-service. While collecting payments before a patient leaves the office can save time and efforts with collections, most providers say that it is an arduous task, as reported an Avality Research study.

“Internally, all healthcare facilities should have an education component. Hospitals are losing money.”

Our Strategies for Healthcare

Today, hospitals and health systems face catastrophic financial challenges, more than any other period in modern history. COVID-19 has disrupted an already fragile financial situation for many hospitals across the nation.
Cancelled non-emergency procedures, postponement of voluntary treatment has dramatically cut revenues and the demands of treatment for COVID-19 patients has increased costs of care exponentially.
Simultaneously, the rate of uninsured and underinsured patients continues to rise. AHA has estimated the cumulative effect of COVID-19 will cost American hospitals and health systems over $200 Billion.
CB2AI™ (Collection Behavior Algorithm) & KYDCB™ enables collectors to benefit from a deeper digital, multi-segmented, treatment strategy that identifies and segments high risk payers to be able to connect them to the right collection agent, yielding a higher dollar collection.
Additionally, it leverages an Omni-Channel Customer Interaction strategy that reduces the frequency of calls, improves contact rates, and provides better overall consumer interaction experience.