Revenue Cycle Management (RCM) in Healthcare Explained.

Revenue Cycle Management means 'getting the bills paid' for hospitals, doctors and other healthcare providers.

The video explains the steps in RCM: 1) PreRegistration, 2) Registration, 3) Charge Capture, 4) Utilization Review, 5) Coding, 6) Claim Submission, 7) Remittance Processing, 8) Follow Up and 9) Patient Collections.

RCM is a $29B a year industry and Becker's Hospital Review has a list of 354 healthcare RCM companies in America.

Accordingly, the RCM industry is highly fragmented meaning 1) there are low barrierstoentry for starting an RCM company and 2) the competence/performance of RCM companies is highly variable.

RCM effectiveness is measured in Accounts Receivable (AR) Days. Hospital AR Days range from 30 to 70, which for a $3B per year hospital system is a difference of $328M in cashflow.

RCM is so complicated that many physicians are selling their practices to hospital systems so that the hospital can take over the RCM and do a better job with it.

Related AHealthcareZ Videos:
Utilization Review:    • Utilization Management Explained  

Medical Coding:    • Medical Coding Overview  

Sources:
https://www.futurewiseresearch.com/he...

https://www.beckershospitalreview.com...

https://revcycleintelligence.com/feat...

https://blog.pmmconline.com/blog/reve...

https://www.amnhealthcare.com/amnins...

https://www.marketplacer.com/blog/how...

https://www.medisysdata.com/blog/calc....