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How to Manage RCM: Five Things to Know

Healthcare service providers are responsible for maintaining their patients’ health and well-being. But how do they retain their stability of financial health for their healthcare practices?

After all, the overall financial health of your healthcare organization is just as important as delivering the best care to your patients. The answer to a company’s continued financial stability is an improved revenue management cycle, which, when absent, often causes chaos.

RCM is responsible for identifying, collecting, and managing the payer-related revenue that enters a practice. Healthcare providers’ administrative responsibilities are reduced with a great RCM solution. In a 2021 Medscape survey, “too many administrative activities” was identified as the main cause of burnout.  An effective RCM helps streamline billing and revenue collection processes and eliminates most medical billing and coding-related challenges faced by a healthcare system.

Common Issues Connected with RCM

Healthcare service providers must deploy the most effective revenue cycle management (RCM) system possible to be successful and better serve their patients, whether they are large hospital networks or specialized physician groups. Patient expectations for healthcare are rapidly changing. Studies show that a negative administrative and billing experience can overshadow a positive clinical outcome. Every encounter in the revenue cycle, from appointment scheduling to final payment, impacts the patient’s experience.

The revenue cycle management procedure can turn as challenging for providers to manage properly. Thus, the common issues faced by RCM are:

  • The denials receive from payers due to clerical errors at the time of patient registration.
  • Improper medical coding procedures lead to payment rejection.
  • Difficulties in handling insurance denials delay the time between meeting the patient and receiving payment for the care.

Most healthcare facilities operating across several specialties still face these issues. However, by implementing some effective ways, these issues can be resolved.

Top Five Ways to Manage Revenue Cycle Management

By being prepared beforehand helps practitioners eliminate unnecessary errors, such as lost revenue, down the line. Here are five tried and tested ways of enhancing and managing RCM for improved output:

Calling the Patient Before Admission

Patient access was one of the leading healthcare revenue cycle risk areas for providers in 2019, according to a 2018 analysis by the public accounting, consulting, and technology firm Crowe. To avoid this risk in your practice, contact the patient by phone or email before their visit and provide them with forms to complete their information. Tell them how payments are collected and processed and how long it takes. As a result, there are fewer registration errors and payment-related misunderstandings at the appointment, enabling revenue on time.

 Integrate Software to Enhance the Revenue Cycle

The practitioners can successfully streamline their procedures, including billing, claim submission, payment administration, appointment scheduling, and more, with the help of integrating RCM with practice management software. This will help to enhance the revenue cycle as the process from the beginning till the time of payment retrieval is synchronized with the help of software.

Care Coordinator

With the assistance of care coordinators, healthcare service providers can better understand the patient’s concerns and difficulties faced during the revenue cycle management process. Additionally, having care coordinators shows patients you care about them and take their issues seriously. This would help to increase patient loyalty, creating a long-lasting prominence for the organization.

Adopt Updated Coding Practices

Adopting coding procedures can increase revenue and reduce insurance companies’ denials of claims. A claim through the adoption of a coding process should be created after services are assessed, and tests or procedures are converted into ICD-10 codes, specific transaction codes established under HIPAA for diagnostic uses. These codes relate to reimbursement.

A healthcare organization can avoid regulatory penalties and delays to the medical workflow by attaining optimal coding compliance. While it can be challenging to manage these processes internally, outsourcing them to experts and professionals who provide a one-stop revenue-cycle management solution can significantly increase revenue.

Regularly Monitor the Key Statistics

To manage RCM efficiently, observe the mistakes in claims filing and billing processes beforehand and resolve them promptly. The practices should evaluate claim denials, their reasons, the time it takes to settle bills, and how frequently patients miss appointments despite repeated reminders to regulate the revenue cycle.


When managing revenue cycle management, a few steps in the correct direction can go a long way. A well-managed and efficient RCM procedure ensures smooth revenue creation and the success of your organization. Additionally, it can help you save time, effort, and money without sacrificing the standard of patient care.


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