Revenue Cycle Management (RCM) Definition

Revenue Cycle Management (RCM) in healthcare refers to the financial process that healthcare facilities and providers use to track patient care episodes, from registration and appointment scheduling to the final payment of a balance. It involves managing the administrative and clinical functions associated with claims processing, payment, and revenue generation.

RCM includes several key steps: patient registration, insurance verification, charge capture, claim submission, payment posting, and managing denied claims. Effective RCM ensures that healthcare providers receive timely and accurate payments for services rendered, reducing the likelihood of revenue loss and improving cash flow. It also involves monitoring and analyzing financial performance to identify areas for improvement in the billing and collection process.