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What is RCM in Healthcare and Why Does it Matter to My Medical Practice?

by guestpost
3 minutes read

Revenue cycle management (RCM) in healthcare is an essential core function of any medical practice. It is the heart and circulatory system of the business. Without RCM, revenue does not pump its way through the business, nor does it supply the funds necessary for the practice to survive and thrive. The RCM function is critical for the very existence of any practice.

Revenue cycle management includes all the functions necessary to connect patient care with practice revenue:

  • Pre-authorization and insurance verification;
  • Coding;
  • Billing;
  • Patient pay;
  • Claims management.

The right practice RCM technologies will streamline these functions and create a highly-productive workflow that prevents losses that can occur from gaps in the RCM system.

Infinix’s RCM healthcare services prove that streamlined workflow can take the place of haphazard revenue practices:

  • Fact: More than 70% of physicians report spending one day or more every week on administrative tasks.
  • Infinix: Saves 32% of practice RCM costs with its medical practice management system and solutions.
  • Fact: Primary care practice nurses now spend an average of 13.1 hours per physician per week on preauthorization. For groups with ten physicians, that’s a minimum of 130 hours a week — fully 65% of the nurses’ time on non-patient care tasks.
  • Infinx provides automated preauthorization for every patient in 15 separate medical specialties, returning nurse’s time to patient care.

One of the most important functions for any medical practice is to have a proven, streamlined revenue cycle management process in medical billing. Exacting billing based on expert coding and precise preauthorization results in better payments, less aging A/R and improved cash flow.

Preauthorization, insurance verification, coding, billing, patient pay and claims management are the most essential steps in revenue cycle management in healthcare practices today. When they are automated and standardized, they become best practices that lead to maximum revenue.

About Infinx’s Revenue Cycle Management Software

Revenue cycle management software is the heartbeat of the practice revenue function. RCM software automates complex functions like preauthorization and insurance verifications and delivers revenue-generating information to staff — when the patient arrives. When staff members know if a treatment is covered, they can engage the patient immediately, educate them about their coverage and engage them in a patient pay plan as needed. RCM software removes costly guesswork from the practice revenue equation.

The best RCM software provides comprehensive solutions for practice needs. Workflow automation software streamlines medical insurance verification, pre-registration, patient pay estimates and preauthorization in one platform to generate maximum revenue.

When you consider RCM software, make sure it meets an exceedingly high bar for excellence and streamlines all RCM functions for your practice.

The best RCM software should:

  • Pre-populate insurance forms according to payer requirements;
  • Place all relevant information in a single window for staff, such as medical necessity and insurance company FAQ guidelines;
  • Incorporate clinical notes, CPT codes, and diagnoses into the preauthorization request;
  • Communicate with insurers through a secure electronic document interface (EDI). That’s what best practice RCM software looks like.

If your staff is performing these functions manually, it’s time for RCM software to streamline workflow and maximize your practice revenue.


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