What is revenue cycle management in healthcare?

Healthcare revenue cycle management is the financial process of collecting payments for medical bills to generate revenue for a healthcare organization. RCM combines administrative data, such as a patient’s personal information, insurer name and treatment codes, with financial billing information.

What are the steps of the revenue cycle?

The seven steps of revenue cycle include preregistration, registration, charge capture, claim submission, remittance processing, insurance follow-up and patient collections.

How does healthcare reimbursement tie into the revenue cycle?

Conclusion. Your reimbursements on claims filed and the money paid out of pocket by patients are the basis of your revenue cycle. The extent to which you effectively manage your payment processes and have a handle on collecting payments that are past due is an indicator of your practice’s financial health.

How do you get CHFP?

CHFP Certification Requirements

1. A minimum of 3 to 5 years of healthcare financial management experience.
2. Passing the CHFP examination.
3. Active membership in the Healthcare Financial Management Association (HFMA)

What are the 10 steps in the revenue cycle?

10 Steps to Boosting Profitability Through the Revenue Cycle

• Audit Claims.
• Root cause analysis.
• Review the claim submission process.
• Fix any system issues.
• Educate the staff.
• Resubmit claims.
• Review, review, review – and then review again.
• Set goals.

Why is revenue cycle management important in healthcare?

Improved Patient Experience Effective revenue cycle management eliminates the redundant processes, simplifies the complexities, streamlines the system. This lowers the administrative burden of the care providers and they focus more on delivering quality care services.

What are the features of revenue cycle management?

The Top Features of Revenue Cycle Management Software for 2020

• Available Via the Cloud.
• Complete Training.
• Submit Claims at the Highest Value.
• Checking Eligibility.
• Claim Tracking and Correction.
• Alerts for Denials.
• Key Performance Indicators and Reports.

What is the best revenue cycle certification?

Earning an AAHAM certification demonstrates a high level of achievement and distinguishes you as a leader and role model in the revenue cycle industry. The certification validates your proficiency and commitment to your profession and can play an integral role in your career strategy.

What does CHFP mean?

Certified Healthcare Financial Professional (CHFP)

What is the first step in the billing revenue cycle?

The first step in revenue cycle management is pre-authorization and registration. This is the point at which you gather the patient’s insurance and financial information.

Which of the following is a goal of revenue cycle management?

The core purpose of Revenue Cycle Management Service is to help medical providers improve profitability and generate sufficient revenue to fund growth and stability.

How to become a healthcare revenue cycle manager?

Those who are considering a career in the financial aspects of healthcare may want to explore an advanced degree. The online Master of Science in Health Information Management program at the University of Illinois is designed to help health professionals achieve a rewarding career in healthcare revenue cycle management and related fields.

What are the KPIs in healthcare revenue cycle management?

The KPIs are net days in accounts receivable (A/R), cash collection as a percentage of net patient services revenue, claim denial rate, final denial write-off as a percentage of net patient service revenue, and cost to collect.

What are revenue cycle costs in health care?

Revenue cycle costs do not represent hard health IT costs, such as hardware expenses, licensing fees, server expenses, and any full-time equivalent staff that support the systems. The costs also exclude lease and rent costs, physical space expenses, and scheduling if the function is performed in the service departments by their staff.

How to become a certified revenue cycle executive?

It doesn’t matter whether you are new to the healthcare revenue cycle or are a seasoned veteran, our family of AAHAM certification examinations offer a complete career ladder beginning with the Certified Revenue Cycle Specialist and culminating with the Certified Revenue Cycle Executive. We have a certification that will help advance your career.