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Revenue Cycle Management

Revenue Cycle Management

Keeping Track of the Claims Process:

One of the critical components of a sound medical billing and coding system is exceptional revenue cycle management (RCM). Revenue cycle management keeps track of the claims process throughout every stage. This allows medical practices to smoothly manage claims processing, payment disbursement, and revenue generation. Exceptional revenue cycle management allows medical providers to prevent billing and coding issues before they occur, as well as handle any emerging issues as soon as they arise. As a result, medical providers can maintain a steady stream of revenue and profitability.

Revenue Cycle Management Process

The revenue cycle management process begins when a prospective patient first calls a medical provider’s office and ends when the patient’s balance is zero. As the name indicates, the process is devoted to overseeing the entire revenue process and streamlining it to ensure the practice receives appropriate payment in a timely manner. As such, the process helps medical practices to reduce financial shortcomings such as delays and denials in reimbursement.

Data Collection

The first stage of any patient interaction is data collection. It’s critical for medical providers to collect data from prospective patients, including personal information and insurance information. Collecting insurance information should ideally be completed when a patient first calls to schedule an appointment. By verifying insurance information beforehand, practices can save time and resources by verifying in advance as opposed to waiting until the patient is in the office. An efficient revenue cycle management program incorporates data collection to ensure that all the pieces are in place for a smooth care and payment process.

Payments and Collections

Claims reimbursement is perhaps the most critical factor in ensuring that a medical provider stays afloat financially. Errors and oversight in this process can result in lost revenue, which can ultimately cause a practice to go under. By implementing a revenue cycle management program, practices can be sure that they’re on top of all payments and collections so that they can be paid as quickly as possible with as little stress and hassle as possible.

Automatic Revenue Cycle Management

At Quest National Services, we can help your practice to establish an automatic revenue cycle management process so that getting paid becomes clockwork. Our advanced tools and technology allow practices to automate several aspects of revenue cycle management, thus minimizing room for human error and missteps in the clinical care and reimbursement process.

Our systems can help to automate virtually all aspects of the process, including:

  • Front office tasks, such as insurance eligibility verification and co-pay processing
  • Patient visit details, such as EMRs and documentation
  • Billing functions, such as real-time electronic claims submission and status tracking

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