Revenue Cycle Management Terminology You Need to Know
A critical component of a successful medical practice is understanding Revenue Cycle Management (RCM). Are you familiar enough with key RCM terms to maximize your healthcare organization’s efficiency and cash flow?
Why RCM Matters
Maybe you think of RCM as administrative busy work disconnected from patient care. Nothing could be further from the truth!
Without a firm grasp of RCM lingo, you risk increased claim denials, delayed payments and missed revenue opportunities. Familiarizing yourself with the language of RCM has many benefits, including:
Streamlining communication with billing staff
Standard and customized reports on charge and payment trends
Ability to understand trends and denial information
Improving decision-making
6 Key Terms to Understand RCM
Whether dipping your toes into RCM for the first time or if you just need a refresher, learning these RCM terms and acronyms is key to maintaining a stable and healthy practice:
Revenue Cycle Management (RCM): The entire lifecycle of a patient account, including billing, coding, claim submission, revenue collection, reporting and analysis.
Explanation of Benefits (EOB): A statement sent by health insurance companies that provides patients transparency on what medical treatments and services were paid on their behalf.
Denial Management: Process of identifying and addressing claims denied by insurers.
Electronic Health Record (EHR): Digital patient charts that enable accurate record-keeping, smoother billing processes and easy sharing between providers and healthcare facilities.
Current Procedural Terminology (CPT®): Codes created by the American Medical Association (AMA) that providers and payers use to communicate billing and insurance purposes of medical, surgical and diagnostic services.
Accounts Receivable (AR): The money owed to a healthcare provider for services rendered.
Onpoint Medical Solutions Can Help
Being an authority on RCM is ideal — but certainly not possible for busy healthcare practices. You want to focus on delivering quality patient care rather than spending time deciphering complex billing codes and claim denials.
Leave RCM to a professional that specializes in everything from coding to denial management. With RCM outsourced, you can enjoy the peace of mind of a thriving business.
Focus on what you do best — caring for patients — and let Onpoint Medical Solutions take care of the rest.