Revenue cycle management is the process healthcare organizations use to track and collect payment for patient care. It covers patient registration, eligibility verification, prior authorization, charge capture, coding, claim submission, payment posting, denial management, accounts receivable follow-up and patient billing.
Good RCM means each step is done right the first time and someone owns the whole process, so revenue is not lost between steps.
Related terms
- Clean claim rate
- The share of claims that pass all edits and are accepted on the first submission.
- Days in AR
- The average number of days it takes to collect payment after a service.
- Denial rate
- The share of submitted claims that payers deny.