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    Revenue Cycle Management

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    Jarjitha A
    This document discusses revenue cycle management (RCM) in the healthcare industry. It describes the medical billing process, which involves registering patients, verifying insurance, submitting claims, monitoring payments, and following up on outstanding balances. RCM tracks all administrative and clinical processes related to capturing, managing, and collecting patient revenue. Key aspects of successful RCM include using technology, training staff, consistency, preventative approaches, dedicated accounts receivable management, and patient education. The document also outlines the durable medical equipment billing process and provides examples of RCM software.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd

    Revenue Cycle Management

    Uploaded by

    Jarjitha A
    461 views12 pages
    This document discusses revenue cycle management (RCM) in the healthcare industry. It describes the medical billing process, which involves registering patients, verifying insurance, submitting claims, monitoring payments, and following up on outstanding balances. RCM tracks all administrative and clinical processes related to capturing, managing, and collecting patient revenue. Key aspects of successful RCM include using technology, training staff, consistency, preventative approaches, dedicated accounts receivable management, and patient education. The document also outlines the durable medical equipment billing process and provides examples of RCM software.

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    This document discusses revenue cycle management (RCM) in the healthcare industry. It describes the medical billing process, which involves registering patients, verifying insurance, submitting claims, monitoring payments, and following up on outstanding balances. RCM tracks all administrative and clinical processes related to capturing, managing, and collecting patient revenue. Key aspects of successful RCM include using technology, training staff, consistency, preventative approaches, dedicated accounts receivable management, and patient education. The document also outlines the durable medical equipment billing process and provides examples of RCM software.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    461 views12 pages

    Revenue Cycle Management

    Uploaded by

    Jarjitha A
    This document discusses revenue cycle management (RCM) in the healthcare industry. It describes the medical billing process, which involves registering patients, verifying insurance, submitting claims, monitoring payments, and following up on outstanding balances. RCM tracks all administrative and clinical processes related to capturing, managing, and collecting patient revenue. Key aspects of successful RCM include using technology, training staff, consistency, preventative approaches, dedicated accounts receivable management, and patient education. The document also outlines the durable medical equipment billing process and provides examples of RCM software.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 12

    Revenue Cycle Management

    &

    DCM Process in Medical Billing


    By
    A.Jarjitha parvin
    2nd year MBA
    Medical Billing
    Medical billing is a payment practice within the United
    states health system. It involves a process of a
    healthcare provider submitting, following up on, and
    appealing claims with health insurance companies in
    order to receive payment for services rendered; such as
    testing, treatments, and procedures.
    HOW DOES MEDICAL BILLING
    WORK?
    1. Patient registration
    2. Confirmation of Patient Financial Responsibility
    3. Patient Check-in and Check-out
    4. Claim Preparation
    5. Claim Transmission
    6. Monitoring Patient Insurance
    7. Generate Patient Statements
    8. Payment Follow-up and handling collection.
    RCM IN Health care
    Revenue cycle Management is the process used by
    health industry in united states to track the revenue from
    patients.

    The revenue cycle includes all the administrative and


    clinical functions that contribute to the capture,
    management and collection of patient service revenue.
    According to the Healthcare Financial Management
    Association (HFMA)

    Error in RCM leads to delayed or no payments.


    Overview of RCM
    Processing of an insurance claim
    ●
    1.Medical services
    ●
    1.Patient appointment
    performed
    ●
    2.Insurance info received ●
    2.Medical records
    and copied
    generated
    ●
    3.Confirmation by patient ●
    3.Patient checkout facility
    Stair 1
    Stair2
    Front
    Provider’s
    office
    entry

    Stair 4
    Payments Stair3
    & Follow Billing and
    up Tracking
    ●
    1.Payment or deniel received with ●
    1.Patient’s data received at
    EOB medical billing company and
    ●
    2. Posted to patient’s account
    ●
    3.Balance due forwarded to patient
    accounts received
    ●
    4.Full payment received or
    ●
    2. Claim generated & generated
    forwarded to collection
    ●
    3.Tracking of claim
    The Essentials of Successful RCM
    Technology
    Well trained staff
    Consistency in process.
    Preventive Approaches
    Dedicated AR Management
    Patient Education
    RCM Softwares.
    Dr Chrono EHR
    Advanced MD
    Kareo Billing
    Athenahealth EHR
    Nexgen office ( Medi tech)
    Compulink healthcare solution
    DURABLE MEDICAL EQUIPMENT
    Durable Medical Equipment (DME) is a
    therapeutic equipment that is prescribed by licensed
    physicians to patients who suffer from
    certain medical condition or illness. Equipment used for
    convenience or beyond reasonable medical needs of a
    patient is not covered by DME billing.

     Examples: Nebulizers, ventilators, kidney machines,


    etc.,  
    PROCESS OF DME IN MEDICAL
    BILLING
    1.Prescription
    2.Verification 
    3.Credentials
    4.Form 
    5.Documentation 
    6.Codes and modifiers
    7.Factory Invoice.
    8.DatesSupporting documents
    9.Coverage
    10.Repairs claims
    THANK YOU

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