Transcription of REVENUE CYCLE MANAGEMENT
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REVENUE CYCLE MANAGEMENT
REVENUECYCLEMANAGEMENTBest Practices GuideREVENUE CYCLE MANAGEMENTI ntroduction ..3 What is RCM? ..4 How does RCM differ from traditional billing? ..5 How can a practice measure financial health? ..6 Days in accounts receivable ..6 Clean claims ratio ..7 Net collections ratio ..8No longer just back office ..10 Front office responsibility ..11 Clinician responsibility ..11 Integrated clearinghouse ..12 Patient responsibility ..13 Value-based payment models ..14 What are value-based programs? ..15 How are physicians paid under these programs? ..15 How is quality measured? ..15 How is cost measured? ..16 Specific value-based programs ..16 How will value-based models affect RCM? ..16 Healthcare s ICD-10 opportunity and challenge: Are you leaving money on the table?
The critical role of effective revenue cycle management (RCM) is unprecedented in healthcare. As multiple regulatory initiatives converge with existing demand for faster billing cycles and cost containment, provider organizations are facing a perfect storm of clinical and financial challenges.
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