Revenue Cycle Management Case Study

718 Words 3 Pages
The relationships between healthcare providers, patients, third-party payers and practice extender create opportunities and challenges for today’s physicians. Engaging external partners to facilitate revenue cycle management can mean the difference between a practice that enjoys a healthy financial status and one that struggles to make ends meet.

How much do Revenue Cycle Management (RCM) Services Cost?

There is not a standard fee for RCM services. Each contract is individually crafted to precisely match practice business goals, patient needs and staff resources. Contracts may cover the end-to-end revenue cycle, or provide only one service, such as coding and billing.

Are RCM services primarily focused on the billing and coding?

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Real-time verification of eligibility and deductible status tools help providers identify each patient’s financial responsibility, enabling practice staff to collect self-pay portions prior to service delivery. For example, knowing that payers like TriWest and TriCare, which typically run secondary to Medicare, have a twelve-month cycle beginning October 1st, and not concurrent with the calendar year, helps frontline staff prepare for exceptions.

Why focus on big data, isn’t that normally associated with retail and finance industries?

Part of effectively using RCM services is leveraging data to gain a realistic snapshot of individual patient groups. Aggregating, analyzing and sharing data via easy to digest reports allows specialists to spot commonalities that otherwise may go unnoticed. Converting data into usable information enables doctors to identify which patients are most likely to pay their bills, follow orders closely and embrace technology assisted scheduling and communication channels.

Is it true that RCM Services can help a medical practice control
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Revenue management tools are only as effective as the staff engaged with the technology and resources. Every RCM service package includes customized training to enable accurate data transfer and reinforce best practices and techniques that allow a practice to utilize the system to its fullest potential.

Are there other ways that services can help medical practice administrators meet business goals?

Yes, one example is reviewing staff workloads and schedules to ensure each employee is working smarter, not harder. Taking a close look at schedules and productivity may reveal opportunities to reassign workers during slow times to focus on practice marketing or patient education.


Revenue cycle management services improve workflow patterns, reduce reimbursement delays, improve patient experiences and help practice administrators proactively manage their cash flow. In today’s healthcare arena, tighter control means more opportunities to improve profit

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