Revenue Cycle Management

Revenue cycle management (RCM) is the process that manages claims processing, payment, and revenue generation. RCM unifies the business and clinical sides of healthcare by pairing administrative data, like a patient’s name, insurance provider and other personal information with the treatment a patient receives. Medical billing software or practice management software is used to manage the patient revenue cycle to produce gainful revenue and provides an easily to track claims status.

Revenue cycle management includes:

  • Pre-billing review & tips on coding
  • Coding Analysis
  • Claims filing and appeals
  • Preparation and delivery of correspondence
  • Billing management
  • Managing inquiries – patients, insurers and regulatory authorities
  • Financial management reports – account receivables and revenue
This includes, but not limits to increase cash flow, patient insurance status, billing and coding efficiently with physician revenue cycle management services for medical groups, anesthesia practices, pathology practices, clinical laboratories, radiology practices, emergency medicine practices, and fire and EMS providers.

We know that hospitals and healthcare organizations are struggling to cope with always changing regulations, shifting to value-based reimbursements as well as consolidations and mergers, which bring forth a unique set of challenges. In such conditions, hospitals focus more on staying profitable rather than take care of the patients, which is crucially nonprofessional etiquette. At MdProHealthCare, we know the main purpose of the hospital is to provide quality care, which is why our revenue cycle specialist aims to help your organization’s operational and financial components at its peak.

MdProHealthCare has decades of experience working with hospitals and healthcare systems. Our team consists of specialist who are well-aware of the pains and challenges that hospitals and healthcare professionals face. Whether your organization is in the process of transitioning to value-based reimbursements or you need assistance in integrating a recently purchased physicians group in to your organization’s system, MdProHealthCare is here to provide complete, customized solutions.