While hospitals, small practices, and larger healthcare systems are known for saving lives and treating patients, every healthcare organization needs to develop successful processes and policies for staying financially healthy. Historically, to manage the administrative and clinical functions associated with claims processing, payment, and revenue generation, the birth of Revenue Cycle Management occurred. The process encompassed the identification, management, and collection of patient service revenue.
It begins when a patient makes his or her appointment to seek medical services and ends when all claims and patient payments have been collected. However, the life of a patient’s account is not as straightforward as it seems.
To start, when a patient arranges an appointment, administrative staff must handle the scheduling, insurance eligibility verification, and patient account establishment.
Measuring the top 10 Key Performance Indicators and having secure processes, proven methodologies and technology that can drive the right behaviors is what makes Revenue Realization Management the new standard. RCM is like using a cell phone from 1990. It can make calls, however, will never be able to stand up against the functionality of today's SMART Phone Technology.
Revenue Realization Management is more than tracking a claim through its entire lifecycle. It's about taking an entirely holistic approach to measuring KPI's by connecting to your data, developing new standards, managing that change towards those new standards, thus allowing you to optimize your overall organizational performance and realize more revenue than you ever have before.