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Importance of Revenue Cycle Management in Healthcare Explained

Valerion Health

June 1, 2023

Importance of Revenue Cycle Management in Healthcare Explained

We understand that as a healthcare solutions provider, delivering quality care quickly and efficiently is priority. No one knows better than you that there’s more to delivering quality care than just treating the patient’s physical symptoms. It is imperative to have an effective strategy in place to manage administrative and clinical functions. It helps ensure that your service providers and medical practitioners receive adequate and timely compensation for their services.

Your patients, your staff and your business can benefit from effective revenue cycle management.

But before we dive into the benefits of revenue cycle management, let’s first underline the fact that the primary purpose of RCM processes is to ensure healthcare facilities and medical practices get paid for the services they provide. It also streamlines and speeds up the reimbursement process.

Here’s a quick look at the steps involved in managing your revenue cycle.

Contents

Importance of Revenue Cycle Management in Healthcare Explained

We understand that as a healthcare solutions provider, delivering quality care quickly and efficiently is priority. No one knows better than you that there’s more to delivering quality care than just treating the patient’s physical symptoms. It is imperative to have an effective strategy in place to manage administrative and clinical functions. It helps ensure that your service providers and medical practitioners receive adequate and timely compensation for their services.

Your patients, your staff and your business can benefit from effective revenue cycle management.

But before we dive into the benefits of revenue cycle management, let’s first underline the fact that the primary purpose of RCM processes is to ensure healthcare facilities and medical practices get paid for the services they provide. It also streamlines and speeds up the reimbursement process.

Here’s a quick look at the steps involved in managing your revenue cycle.

5 Steps in Revenue Cycle Management

  1. Ensure all relevant data generated during patient and staff interaction is synced. It’s crucial to ensure that this data is accurate and is stored properly because all other steps rely on this information
  2. Next, thoroughly check the information entered and ascertain that precise codes are in place. As the reimbursement amount is decided by a universal medical code assigned to each service, incorrect codes could ultimately affect your revenue
  3. Submit your data to the insurance provider for reimbursement claims
  4. Communicate and follow-up with your insurance companies regularly to stay updated about the status of pending payments
  5. Once your insurance company pays the portion allocated to the services, you can request the patient to clear the remaining balance

Benefits of Effective Revenue Cycle Management

Hassle-Free First Submission Claims

One of the critical goals of revenue cycle management is to complete routine tasks and make sure claims are settled after first submission. Verification, collecting and collating patient information and coding are some examples of routine tasks that can be streamlined by efficient RCM processes. Roughly only 3.8% claims are denied on the first submission with technical issues and human errors being leading denial causes.

Increase in Practice Collections and Revenue

As a healthcare organization, you have to bear several expenses including paying for the services provided to patients and administrative staff. Denied claims and delayed payments can make it difficult to run operations smoothly. The importance of revenue cycle management is highlighted by the fact that it helps you get to the root cause(s) of denials. You can take corrective measures to receive timely reimbursement by assessing the patterns

Refocus Time & Minimize Errors

Effective revenue cycle management can be empowering as you no longer must spend additional time, energy and resources to correct errors and submit claims. A combination of skilled professionals and advanced technology can simplify the process and minimize errors, allowing you to focus on what matters the most—delivering quality patient care.

Enhanced Patient Experience

One of the key benefits of effective revenue cycle management is improved patient experience. Not only do they receive better quality and targeted healthcare, getting appointments, filling forms and processing bills also become convenient. Effective RCM processes include upfront insurance verification so patients can be made aware of their insurance eligibility well before their treatment begins so they are not kept in the dark until the last minute.

Reduced Administrative Burden

From scheduling appointments, recording and updating patient data to verifying insurance claims and perhaps even processing bills—your staff does it all. One of the benefits of revenue cycle management is that all these essential tasks are well-organized and updated allowing administrative staff to perform their duties more efficiently. Additionally, these tasks are completed with greater accuracy, reducing your chances of claim denials due to errors.

For more than two decades, Valerion Health has been empowering healthcare organizations with customizable, end-to-end revenue cycle management solutions. Benefit from our experience and expertise by getting in touch today.

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It has come to our attention that certain unauthorized individuals, impersonating Valerion Health Inc., have been sending fraudulent job offers and misleading communications, including sending checks to prospective employees for setting up remote workstations.

We would like to specifically mention Blake Goss and Taylor S. Butterton, who have been falsely representing themselves as agents/recruiters of Valerion Health Inc. using the email address blake@valerionhealthcareers.com. Please note that this domain is not affiliated with our company, and any communication from such addresses should be regarded as fraudulent.

Valerion Health Inc. strictly adheres to a genuine recruitment process and does not send checks or request any form of financial involvement from candidates. Any communication suggesting otherwise is a scam.

Here are some key warning signs to help identify such fraudulent schemes:

  • Requests for checks or money transfers to “set up” remote positions
  • Emails from unauthorized domains like com
  • Job offers that seem too good to be true or are unsolicited
  • Discrepancies in company branding and communication

If you receive any suspicious offers or communications on behalf of Valerion Health Inc., please report them directly to our team at JoinUs@valerionhealth.com. We also advise anyone impacted by these scams to promptly notify the relevant law enforcement agencies. 

Stay vigilant, and together, let’s combat these fraudulent activities.

Sincerely,
Team Valerion Health Inc.

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