10 Steps Of Medical Revenue Cycle Management (RCM)

Medical revenue cycle management process involves the revenue reimbursement to healthcare providers in return for their services, either from the government or either from private organizations. The process helps medical facilities generate revenue through efficient RCM management. RCM also ensures to remove any defect that can lead to a claim denial or eventually revenue loss.

The medical revenue cycle management process starts from the scheduling of patient consultations to the recovery of reimbursement. The cycle involves the following 10 steps:

Step 1: Patient Registration

At first, the healthcare staff registers the patient consultation in the RCM program, where all of the patient’s details are filled in.

Step 2: Attendance

The patient itself comes to take a consultation, where appointment details are collected.

Step 3: Coding

Health staff then identifies the medical RCM code according to the patient’s info.

Step 4: Claim Submission 

When the reimbursement application is ready, the claim is submitted to the reviewer electronically. 

Step 5: Status Tracking

After the claim submission, its status is constantly checked to analyze if there’s any rejection by the reviewer.

Step 6: Claim Return

The provider reviews the claim. Either he provides the reimbursement or either he denies the claim.

Step 7: If The Provider Rejects The Claim

If your medical billing claim has been denied, the revenue provider returns it by determining a problem that your staff is required to solve.

Step 8: Revenue Collection

If the claim is approved, reimbursement is made by the provider in the medical billing program.

Step 9: Bill Process

After receiving the reimbursement, the staff sends the medical bill to the patient. But mostly it is done automatically with the help of technology. 

Step 10: Complete The Process

At last, health staff makes sure that patients get and pay their bills on time.
These were the 10 steps involve in medical revenue cycle management that makes the process easier to conduct.