Revenue Cycle Management
Simply put, the whole process of maximizing revenues from patient care can be termed as “Revenue Cycle Management”. This includes everything from eligibility verification to claim submission to payment posting to Receivables management. A Revenue cycle management system is usually a part of a sophisticated Practice management system which would also include appointment scheduling and advanced reporting, among other things.
A robust Revenue Cycle Management system plays a very important role in maximising Revenue realisation and reducing the DAR (Days in accounts receivable) and denial rates. These systems would pre-empt any obvious claim submission issues arising due to insufficient data, coding errors etc, track these claims effectively after they are submitted and then accurately post payments using ERA. Having custom claim workflows and intutive data reporting capability goes a long way in ensuring the financial health of Practice. These systems support HIPAA mandated ANSI X12N transactions and are interoperable enough to be plugged in to any existing legacy system. Cybage has an in-depth understanding of the enitire Revenue Cycle management process and has helped its clients develop solutions which encompass the feature list below:
Some of the features or components of Practice / Revenue Cycle Management solutions are
Some of the features or components of Practice / Revenue Cycle Management solutions are
- Appointment Scheduling
- Copay / Selfpay Collection
- Claim Cycle
- Electronic Claim submission
- Electronic Claim Tracking
- Electronic Payment Posting (ERA)
- Denial Management workflows
- Custom claim workflows
- Reporting Systems
- Ad hoc reporting
- Dashboards
- Data warehouses / Data mining