What is Revenue Cycle Management?

Revenue Cycle Management (RCM) is a crucial aspect of the healthcare industry, as it involves the financial management of a patient’s medical journey from registration to final payment.

The revenue cycle process is complex and involves various stages, such as patient registration, charge capture, coding, billing, denial management, and payment posting.

With well over 20 plus years combined experience we understand the various nuances of the revenue cycle, how to maximize reimbursement and assist your practice with providing excellent patient satisfaction. We view ourselves, in fact, as an extension of your practice and see to it that your patients are as satisfied with their billing experience as they are with their visit to your office or facility.

What is Involved in Revenue Cycle Management?

Patient Registration

The revenue cycle process begins with patient registration, where the patient provides their personal and medical information.

Accurate and complete patient information is critical to ensure proper billing and reimbursement. RoundTable Medical Consultants offers tools that verify patient eligibility, insurance coverage, and demographic data to ensure accurate registration.

This step ensures that patients receive appropriate care, and providers receive payment for services rendered.

Charge Capture and Coding

Charge capture refers to the process of recording and tracking patient services provided by healthcare providers.

Accurate charge capture is essential to ensure proper billing and reimbursement. RCM service providers offer tools that automatically capture charges and apply appropriate codes to ensure accurate billing.

This step is critical as errors can lead to denied claims and delayed payments.

Billing and Claims Submission

Billing involves the generation of a claim for the services rendered by healthcare providers.

The claim is then submitted to the payer for reimbursement by the revenue cycle management provider.

With automated billing processes, electronic claims filing and front end edits, RTMC ensures timely and accurate submission of claims, reducing the risk of denials and delays in payments.

Denial Management

Denials can occur when a payer rejects a claim due to errors in coding, incomplete information, or lack of medical necessity. Payers can also under pay claims, especially for out-of-network providers. RoundTable Medical Consultants (RTMC) has a large team of experts who review your claims and work with the various payers to ensure you are getting maximum reimbursement.

Payment Posting

Payment posting involves the reconciliation of payments received from payers with the claims submitted.

RTMC can establish electronic payments for your practice so that you get your money fast and hassle free. Ask about how we can assist with EFT/ERA enrollments.

We also offer manual posting for smaller carriers and can even assist you with setting up a lockbox.
With line item posting and daily, weekly, monthly and yearly reconciliation, every penny is accurately accounted for and posted to the correct patient’s account.

Benefits of Outsourcing Revenue Cycle Management Services

1. Improved Financial Performance: RTMC helps healthcare providers improve their financial performance by optimizing the revenue cycle process. Accurate and timely billing and claims submission ensure timely payment for services rendered, reducing the risk of lost revenue due to denials and delays.
2. Reduced Administrative Burden: RTMC offers tools that automate the revenue cycle process, reducing the workload on administrative staff. Automation reduces the risk of errors and ensures timely resolution of outstanding claims.
3. Improved Patient Satisfaction: The revenue cycle process can have a significant impact on patient satisfaction. RTMC offers solutions that improve the patient experience by ensuring accurate and timely billing and reducing the risk of denials and delays.
4. Compliance with Regulations: RTMC ensures compliance with regulations, such as HIPAA and CMS guidelines. Compliance reduces the risk of fines and penalties, ensuring that healthcare providers operate within legal and ethical boundaries.
5. Increased Efficiency: At RTMC, we optimize the revenue cycle process, reducing the time and resources required to manage the process. This results in increased efficiency, allowing you to focus on delivering high-quality patient care.