RCM: What it is and How Aptus can Help You

Home > RCM: What it is and How Aptus can Help You

September 6, 2018 | Aptus Associates

Your rural medical office needs to be run like a business in order for it to be successful and stay open. After all, it is a business! With this in mind, one key aspect is keeping track of your revenue stream, known as revenue cycle management (RCM). RCM is the financial process that healthcare facilities like you use to track patient care episodes from registration and appointment scheduling to the final payment of a balance. It unifies your business side with your clinical side by coupling administrative data, such as a patient’s name, insurance provider and other personal information, with the treatment that patient received and their healthcare data.

Here is what’s involved in the revenue cycle that you’ll need to keep track of:

#1 Preregistration: You never want to be taken for surprise. That is why collecting preregistration information, such as insurance coverage, before a patient arrives for their procedures needs to be handled.

#2 Registration: This step involves collecting subsequent patient information during registration to establish a medical record number and meet various regulatory, financial, and clinical requirements.

#3 Charge capture: Your team renders medical services into billable charges.

#4 Claim submission: Someone submits claims of billable fees to insurance companies.

#5 Coding: Properly coding diagnoses and procedures is essential to move forward.

#6 Patient collections: You need to get paid! This step involves determining patient balances and collecting payments.

#7 Remittance processing: Applying or rejecting payments through remittance processing is an arduous process, but it needs to be done.

#8 Follow up: Collecting payments may be difficult, and you may need help from third-party insurers to do so.

#9 Utilization review: Last, be sure you are examining the necessity of medical services provided.

Does that sound like a lot to keep track of? It doesn’t have to be! Outsourcing your medical billing services removes the complicated and time-consuming task of revenue cycle management (RCM) from your busy medical practice and places it in the hands of experienced professionals. Aptus offers a complete Billing and Accounts Receivable Management package to medical offices just like yours- primary care and specialty practices, rural health clinics, professional radiology practices, palliative care offices, and hospitals. For more information on how we can help you, please either call 1-888-760-2455 or email info@aptussupport.com. If you prefer, you can fill out our simple online form.