Income Cycle Management (RCM) in Healthcare Explained.
Earnings Cycle Management implies ‘getting the expenses paid’ for medical facilities, physicians and other doctor.
The video discusses the actions in RCM: 1) Pre-Registration, 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 market and Becker’s Hospital Review has a list of 354 health care RCM business in America.
Appropriately, the RCM market is extremely fragmented significance 1) there are low barriers-to-entry for beginning an RCM business and 2) the competence/performance of RCM business is extremely variable.
RCM efficiency is determined in Accounts Receivable (AR) Days. Medical facility AR Days vary from 30 to 70, which for a $3B each year medical facility system is a distinction of $328M in cashflow.
RCM is so complex that numerous doctors are offering their practices to healthcare facility systems so that the medical facility can take control of the RCM and do a much better task with it.
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