Question

Describe the importance of revenue cycle management in the acute care environment and the impact it can have on the healthcare organization. In your description be sure to identify the consequences of improper revenue cycle management as it pertains to the healthcare organization as a whole.

Answer 1

Revenue Cycle Management is how the organization manages the client’s claim processing, payments and the revenue generation from the initial appointment till discharge. The appointment scheduling offers the opportunity to gather enough information for the claim process such as insurance information and verifying the eligibility. Besides this, ensuring that the patients have eligible insurance on file can help in determining the costs of different treatments. Faster and more accurate claim transmission allows providing various treatment options for the patient. The problems and issues related to RCM process in healthcare can impact the patient care.

Claims can be rejected due to a wide range of problems such as lack of information, improper coding, compatibility issues, and system errors. Usually, these errors occur due to the lack of training for the staff, communication problems between the staff and departments, and the workflow related issues. All these failures can result in a huge revenue loss of the healthcare organization. Therefore, effective management of RCM process is important to reduce the number of bad debt.