Understanding the Healthcare Revenue Cycle

In order for a company to sustain its growth, it has to make sure that all revenues are collected on time. In order for this to happen, hospitals and most medical institutions make use of what is known as the revenue cycle management.

What is Healthcare Revenue Cycle?

A hospital or healthcare revenue cycle typically starts as soon as the patient sets foot on the clinic and ends as soon as he or she has settled all of his pending bills. Proper management of this cycle can help ensure the profitability of a hospital or any healthcare provider.

Proper Management of the Revenue Cycle

Since proper healthcare revenue cycle management is important in ensuring the soundness of a business, you plan carefully what your steps would be. For one, you need to make sure that you have the proper tools for gathering data. This should include information provided by the client right from the start. Keep in mind that, if you have the proper tools, you would be able to easily verify client information as well as insurance records which, in turn, can help you room your patient with very little waiting time involved.

It is also a good idea to properly monitor also your claims denial rate as well as the reason for such denials. Now, when it comes to claims denials, there are two ways on how to handle it – you ensure that you have a low denial rate by reviewing thoroughly insurance and health care coverages, and by making ensuring that your process can easily detect and work on the reasons for the increase in denials.


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