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Revenue Cycle Management (RCM)

Revenue Cycle Management (RCM) is a crucial process in healthcare that ensures medical providers receive timely payments for services rendered. It starts with patient registration and insurance verification, ensuring accurate information collection to prevent claim denials. Medical coders then translate diagnoses and procedures into standardized codes, followed by charge entry to generate claims. These claims are submitted to insurance providers, and payment posting specialists reconcile reimbursements while identifying underpayments. Denial management plays a key role in rectifying rejected claims and filing appeals to recover revenue. Additionally, patient billing ensures transparent invoicing and efficient collections. A well-optimized RCM system improves cash flow, reduces administrative burdens, ensures compliance with healthcare regulations, and enhances overall financial stability for providers. By outsourcing RCM, healthcare facilities can maximize revenue, minimize claim denials, and focus on delivering quality patient care.

Key Benefits:

  •   Reduces claim rejections due to incorrect patient information
  •   Ensures eligibility and coverage verification upfront
  •   Enhances the patient experience by avoiding unexpected charges

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