Revenue Cycle Management Services
Expert support to navigate the complexities of medical billing reimbursement and maximizeÂprofitability
Full RCM Solutions from start to finish
Revenue Cycle Management is the process used by healthcare systems in the United States to track their patient revenue from their initial appointment or encounter with the healthcare system to their final payment of balance. This process involves several key steps that help healthcare providers optimize their financial performance and ensure timely payments. The cycle can be defined as “all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue”. It is a cycle that describes and explains the life cycle of a patient (and subsequent revenue and payments) through a typical healthcare encounter from admission (registration) to final payment (or adjustment off of accounts receivables). Efficient revenue cycle management is essential for healthcare organizations to maintain financial stability and provide quality care to patients.
Credentialing
Credentialing involves reviewing various documents to determine if an individual is eligible to participate in a health plan. This includes assessing educational background, training, clinical privileges, work experience, licenses, accreditations, certifications, insurance coverage, any history of malpractice, and overall professional competence. Both the initial credentialing and recredentialing processes require collecting, examining, and verifying information for accuracy and completeness.
