Healthcare Revenue Cycle

Revenue Cycle Management Company in the USA

The healthcare revenue cycle is the complete financial process from the moment a patient contacts the organization for treatment, through the registration process, verification of insurance, services rendered, coding and billing, claims process, and patient billing.

The goal of healthcare revenue cycle management is to ensure that the financial process is streamlined and that payment for services rendered is obtained as quickly as possible. Healthcare organizations must pay their bills to remain in operation, and Genesis Medical Management provides revenue cycle management services to help them effectively control this process.

When a patient schedules an appointment, administrative staff must complete the patient registration process, confirm insurance eligibility, request authorization if required and set up a patient account with insurance coverage information. Accuracy during this process is a crucial step in the healthcare revenue cycle. Without proper information for the patient, claims cannot be submitted and collected on their behalf. The top reason for insurance claim denials is eligibility and authorization issues, so verification of insurance eligibility is crucial.

Healthcare Revenue Cycle Management Services in the USA

Once a patient has received services, the next step in the healthcare revenue cycle is to ensure the proper information is obtained for submitting claims to the insurance companies. Administrative staff must identify the nature of the services provided and establish the proper billing codes. Some top reasons for claim denials from insurance companies is improper billing codes and incomplete information for services provided.

The process of claims reimbursement can be lengthy. There can be multiple communication moments between the provider and the private or government entities providing the insurance, usually due to incomplete information or incorrect billing codes. Dual insurance coverage can make the process even lengthier. Once payments have been received, they must be posted, statements generated, and claim denials handled. Once all insurance payments have been obtained, any remaining balances must be billed to the patients. Those invoices must be generated, and payments processed.

The process of the healthcare revenue cycle can take months, with claims information going back and forth between provider and insurance companies to obtain all the correct patient information and correct billing codes for services rendered. The goal of Genesis Medical Management is to provide revenue cycle management services that increase efficiency to collect full payment in the shortest time possible.

One of the best ways to improve healthcare revenue cycle management is by embracing technology. Revenue cycle software can help to streamline processes and provide more accuracy. Software automates many of the processes, including coding, insurance verification, billing, scheduling, etc. Staff who are properly trained on completing patient registration working with automated software, can eliminate many claim denials. Software can also help healthcare organizations to monitor claims processes closely throughout the lifecycle of the claims. Software combined with proper staff training can reduce medical record errors and lower turnover rates.

Contact Genesis Medical Management and take the first step toward improving your healthcare revenue cycle management.