Healthcare Compliance at Ankura includes advisory services for Revenue Cycle Management (RCM). You may wonder, what is RCM and why is it important? It is a common misconception that RCM is a finance concept that does not impact the rest of the organization when in fact, a well-functioning revenue cycle not only improves a company's financial performance but also creates more satisfied patients by streamlining and simplifying the payment process.
So, what is Revenue Cycle Management? RCM is the process used by healthcare systems to track revenue and collect cash. The Revenue Cycle consists of three primary phases:
Within each phase, there are numerous activities that contribute to an efficient RCM process, starting when a patient makes an appointment and ending when all the claims and payments from the patient and insurer have been collected. Successful completion of each step along the way is reliant on having the right people, processes, and technology to support it. The revenue cycle is truly a “cycle” - each step feeds the other and the success, and efficiency of each step depends on other steps. When full payment for a service has been received and reimbursement has been attained, the cycle ends.
One pain point in RCM is denials – the inability to collect for services rendered. Implementing processes to reduce denials is critical to a successful RCM, as well as overall...
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