what is rcm in healthcare

Revenue Cycle Management (RCM) is the financial process that healthcare facilities use to track patient care episodes from registration and appointment scheduling to the final payment of a balance. RCM unifies the business and clinical sides of healthcare by coupling administrative data, such as a patients name, insurance provider, and other personal information, with the treatment a patient receives and their healthcare data. The process consists of identifying, managing, and collecting patient service revenue. An RCM system can also save healthcare organizations time by automating duties that were previously handled by employees, such as informing patients of upcoming appointments, reminding payers and patients of an existing balance, and reaching out to insurers with specific questions when a claim is denied. RCM systems can also save providers money by giving them insight into why claims have been denied and cutting down on denied claims by prompting. At its core, the revenue cycle represents a complex business interaction with patients that entails many touchpoints. Mismanagement of these functions can lower patient and clinical satisfaction scores and damage the reputation of the organization through avoidable denials and bad debts. Proper RCM dashboards can complement metrics by allowing healthcare companies to monitor the revenue they receive from patients from the beginning of their care process to the end, providing them with data that facilities can use to improve practices and patient care.