What is Revenue Cycle Management in Healthcare?

Understanding Healthcare Revenue Cycle Management (RCM)

With revenue cycle management services, you can remain aware of the patient’s registration and appointment scheduling up until the date that the final payment is made.

Revenue cycle management (RCM) can be defined as the link between the financial and clinical activities of the health care practice. If a practice’s finances fall behind, so too will their ability to provide their patients with the care they not only want but need.

What Does Revenue Cycle Management (RCM) Do For Healthcare?

Answer: RCM should eliminate mistakes and omissions that result in rejected claims and cost your practice valuable time and money.

Naturally, many complications can come with sorting the bills of patients internally, mostly when it has to do with health insurance. Insurance companies work in such a way that if there is a single issue with the payment document, the claim is rejected. Rejection of claim applications is a significant problem for practices, but with the help of InSync’s Revenue Cycle Management team coupled with the InSync billing software, healthcare organizations can expect clean claims. Resulting in boosting their reliability both with billers and with their patients.

The financial aspect of every organization can be affected by a variety of factors, some internal, some external. Internal factors include provider productivity, patient volume, and the fees levied on multiple services. External factors are patients’ payments, claims, and reviews. Especially those that have to do with insurance companies, taxes, and other additional fees. However, the internal factors are often impacted by the external ones. Yet with the help of InSync’s RCM services, both can be adequately managed so that a practice’s overall productivity is not affected.

Internal factors include:

• Provider Productivity

• Patient Volume

• Fees levied on multiple services

External factors include:

• Patients’ Payments

• Claims

• Reviews

• Insurance Companies

• Taxes

• and other additional fees

Trusting your practice's finances to the  InSync Healthcare Solutions revenue cycle managers can save a healthcare organization not only money but also time. This combined savings makes the practice more effective overall.

What You Get With InSync Healthcare Solutions

At InSync Healthcare Solutions, we offer more than a traditional in-house billing department or accounts receivable can. 

More Resources for RCM. 

We simply have more staff than a traditional practice would be able to afford to task solely with billing. This enables us to handle your workload regardless of how inundated you may feel. 

We're Industry Experts.

Our staff stays on top of healthcare industry regulatory and billing requirements that most practices struggle to keep up with. It's understandable, most healthcare professionals in a management role are busy enough running the practice and overseeing the day to day operations. Our revenue cycle managers are seasoned healthcare industry veterans and stating on top of HIPAA compliance comes easy to them.

Go Beyond Traditional Service.

Traditional services would be satisfied with sending out claims to the different payers and that being enough. We take a proactive role and follow up on the claim. We take time to make sure that everything that needs to be on the claim is, and that everything on the claim is accurate 100% of the time. 

A Revenue Cycle Management Case Study

Capstone Behavioral Health, a three-location behavioral health practice in Nebraska, strives to improve the quality of life for individuals and families with mental health and substance abuse needs. As part of our case study, we spoke to Capstone's Director of Operations, Nikki Conner on what business was like before adding InSync Healthcare Solutions Revenue Cycle Management service. 

We were planning to only switch to another EHR system and remain with the same RCM solution. But when we started looking over our RCM data – such as our A/R numbers and Days Out – it was clear we were struggling to receive our proper reimbursements.

Implementing one software for a medical practice is a major undertaking, so going live with both a new EHR and RCM solution should have been a stressful process. However, it was InSync Healthcare Solutions' hands-on approach to implementation that helped the entire period run smoothly and efficiently.

For Capstone and any other clients, InSync Healthcare Solutions provides practices with the option of bringing implementation team members to the practice for an on-site discovery, which allows for a more in-depth understanding of how the practice works. As a result, the software is better customized to fit the unique needs of the practice, an important factor in a software’s effectiveness, especially for Capstone Behavioral Health.

We are much more hands-on, knowledgeable and informed about what’s going on in our business thanks to InSync's RCM tools. It’s all completely automated so we can be confident everything is done right.