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REVENUE CYCLE MANAGEMENT (RCM) refers to the process of identifying, collecting and managing the revenue from payers based on the services provided. A successful RCM process is critical for a healthcare entity to maintain financial viability and enhance patient experience.

REVENUE CYCLE MANAGEMENT CHALLENGES 

  • Bad information and miscommunication
  • Timely access to data
  • Patient Communication Channels
  • Coding complexities
  • Medical billing errors
  • Denial Management
  • Claims payment
  • Compliance adherence
  • Staffing
  • Self-pay and patient responsibility billing and collections
  • Information Technology

MANAGING THE RCM PROCESS

Our focus on examining and improving your organization’s Revenue Cycle Management core operations systems will allow the provider to focus on patient care rather than worry about financial viability. Our methodology developed in conjunction with the Healthcare Financial Management Association (HFMA) and ACA International’s best practices focuses on the early detection of issues and communication. Our mantra is, “Communication is key!”. Our RCM solution will create customized reporting that addresses key metrics to show our returns and value precisely—some of these key metrics are the following: 

  • Net Collection Rate (%)
  • Bad Debt Rate (%)
  • Days in Accounts Receivable (AR) (#)
  • Daily Sales Outstanding (DSO)
  • Gross Collection Rate (%)
  • Denial Rate (%)
  • Percentage of unbilled (unclean) claims (%)
  • Average and median price per accession ($)
  • Average and median reimbursement per accession and by test classification ($)
  • Month-over-month revenue by client, procedure and payor ($) procedure 
  • Operating margin (%)
  • Periodic Coding Reviews
  • Patient Satisfaction Survey’s
  • Patient Social Media Engagement
  • Quarterly Review and Recommendations
  • Rolling AR by Payer and Provider

For a free RCM assessment, contact us or call now (850) 862.2134

RCM Service Lines:

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Extended Business Office

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Credentialing & Contracting

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