Revenue cycle management or RCM is a combination of revenue generation, payment, and
claims processing. In layman’s terms, it is a healthcare system’s financial system.
Its components include all clinical and administrative functions that consist of the
management, collection, and capture of revenue gained from patient service. It is
primarily the entire lifespan of a patient account in a healthcare organization. Revenue
cycle management incorporates the use of specific technological tools to track claims
throughout patient’s lifecycle, ensuring that the payments are collected without any
hurdle, and claims are addressed successfully. RCM tools let healthcare providers
do the billing and identify issues quickly, thereby allowing for the secure stream
of revenue. A system that runs efficiently thwarts rejection of claims and preserves
an efficient and transparent billing process. Revenue cycle management also includes
everything from deciding on patient’s insurance adequacy and eligibility to regulating
claims through ICD-10.