Revenue Cycle Management

Revenue Cycle Management or RCM typically refers to the entire medical billing processes – from beginning to end including Data Capturing, entering, and editing the information needed to create a medical billing claim (to an insurance company or payer) till the collection and deduction analysis of claims. This includes “demographic” information about the patient including insurance coverage details and “charge” information: a combination of CPT and ICD-10 codes determined by the physician or a coder.

The objective is to assure payment is made on a timely basis. We analyse underpaid / short payment claims by comparing payments to package rates agreed with the panels and flag exceptions wherever necessary. Follow-up on these claims are critical to achieve strong collection results. Reporting is frequently viewed as an integral part of the revenue cycle, since it reflects the results and statistics about practice health, both financial health and operational health (e.g. productivity).