Revenue Cycle Management (RCM) in Healthcare Explained.
Revenue Cycle Management means 'getting the bills paid' for hospitals, doctors and other healthcare providers.
The video explains the steps in RCM: 1) PreRegistration, 2) Registration, 3) Charge Capture, 4) Utilization Review, 5) Coding, 6) Claim Submission, 7) Remittance Processing, 8) Follow Up and 9) Patient Collections.
RCM is a $29B a year industry and Becker's Hospital Review has a list of 354 healthcare RCM companies in America.
Accordingly, the RCM industry is highly fragmented meaning 1) there are low barrierstoentry for starting an RCM company and 2) the competence/performance of RCM companies is highly variable.
RCM effectiveness is measured in Accounts Receivable (AR) Days. Hospital AR Days range from 30 to 70, which for a $3B per year hospital system is a difference of $328M in cashflow.
RCM is so complicated that many physicians are selling their practices to hospital systems so that the hospital can take over the RCM and do a better job with it.
Related AHealthcareZ Videos:
Utilization Review: • Utilization Management Explained
Medical Coding: • Medical Coding Overview
Sources:
https://www.futurewiseresearch.com/he...
https://www.beckershospitalreview.com...
https://revcycleintelligence.com/feat...
https://blog.pmmconline.com/blog/reve...
https://www.amnhealthcare.com/amnins...
https://www.marketplacer.com/blog/how...
https://www.medisysdata.com/blog/calc....