Tuesday, 17 October 2017

Revenue Cycle Management: The Smart Billing Technology

Healthcare providers require to maintain a balance between care-based models and traditional revenue cycle management. This has brought with it radical changes in terms of trends such as digitization, automation, and centralization of healthcare management and workflow. Rapid increase in the speed of billing cycle, financial challenges, and expansion of the healthcare industry have contributed to the demand for revenue cycle management (RCM) solutions.


Understanding RCM

RCM or revenue cycle management is a financial process that uses medical billing software to keep a track of patient care, right from appointment scheduling and registration to final payments and settlements. RCM is designed and extensively used by healthcare facilities, namely physician offices, diagnostic laboratories, hospitals, etc. 

Noteworthy Recognition

Aprima Medical Software, a Texas, U.S.-based company, introduced the Aprima RCM platform, which merges smart technology with billing expertise. The system assists practices in eligibility check, claims editing, and optimizing costs and collection with the help of better denial management. 

The company’s software and services help find likely coding oversights in billing equipment used, notifies the practice of any amendments in regulations, and compares contacts to spot any possible underpayments, which could affect the growth of the practice. The platform also improves the firm’s financial performance. 

It also includes CMS Medically Necessary Rules, prepayment audits, and ICD-10 coding, increases reimbursements, and helps the practice adhere to objectives of the physician quality reporting system (PQRS).

Market Insight

According to a new report by Grand View Research, Inc., the revenue cycle management (RCM) market is expected to reach USD 65.2 billion by 2025. Need to improve patient care, reduce diagnostic costs, and decrease machine downtime can drive the revenue cycle management market.

Some major competitors in the revenue cycle management market are Allscripts, CareCloud Corporation, The SSI Group, LLC, and NextGen Healthcare Information Solution LLC.

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