The revenue cycle management (RCM) process is one of the most fundamental parts of an efficient and functional healthcare entity. The vitality of this process to the healthcare industry as a whole cannot be understated, and it continues to grow with each passing year. In fact, it is predicted that the RCM market will reach more than $43 billion by 2022, emphasizing the increasing importance RCM has for healthcare providers. By offering the process by which healthcare providers receive reimbursement for their services from insurance providers, good RCM can be the difference between sinking and swimming for healthcare facilities.
In understanding the factors that go into an effective RCM process, it’s important to note the key aspects that successful RCM processes tend to share. These fundamentals all contribute toward creating an RCM process that brings the best results for healthcare facilities while minimizing their pain points and streamlining the experience for patients. Healthcare providers would do well to examine their RCM processes carefully and determine whether or not these key fundamentals exist within their systems. If not, they may need to take a stark look at their processes and make significant changes if they are to have any hope of functioning at optimal efficacy.
For example, high accuracy is one of the most fundamental features of a fruitful RCM process. Without high accuracy, the data healthcare providers use to optimize their processes may be lacking, leaving them open to making serious errors in judgment. In turn, creating a domino effect that can have terrible effects on the rest of their RCM framework. Successful RCM processes also must include a physician advisory module or component that can provide physicians with the resources from which they can navigate the regulatory environment with better success and ease. This can reduce obstacles that are encountered commonly with regards to legal requirements — in effect, streamlining the entire RCM process.
This infographic from R1 RCM explains these and the many other aspects that go into creating a successful RCM process. Understanding these key components only becomes more important all the time. Meaning, there’s no excuse for not getting started on building a better RCM process today.