Revenue cycle management
It starts when a patient books an appointment, and it includes registration, insurance verification, coding, claim submission, payment posting, denial management and patient billing. It ends only when the balance is collected.
A practice can deliver excellent care and still struggle financially if the revenue cycle is weak, which is why RCM is treated as an operational discipline in its own right.
- Front end: scheduling, registration, eligibility.
- Middle: charge capture, coding, claim submission.
- Back end: payment posting, follow-up, denials, patient billing.