Importance of Revenue Cycle Management in Healthcare

One of the prominent issues in the field of healthcare is the collection of revenue. There have been many laws created that basically focus on keeping a close eye on the revenue collected and the overall medical billing of the sector. The re-modifications at the legal level and the high regulation in the industry, however, make it quite challenging for the healthcare providers to gather the dues in the right manner. That is when the role of revenue cycle management

Importance of Revenue Cycle Management in Healthcare

comes into existence.  It helps to ensure the losses that usually accuse because of poor technology and lack of insurance providers involvement can be avoided

What exactly is revenue cycle management?

In today’s time, software and technology advancement has improved to a great extent. That is why the concept of revenue cycle management has also managed to earn quite a great demand. This is one of the crucial parts of the health care sector in today’s time. Even the estimates state that such an industry is likely to grow by 12% by the year 2026. In order to sustain the organization and avoid any more losses, the role of such a technique must be understood in depth.

The process that is a part of revenue cycle management

The management cycle includes all kind of process that is associated to the finances that are part of the healthcare organization. It also consists of the cost that is related to all patient care processes right from the beginning till the end. It also begins with the first encounter that patient ever had in the clinic till the overall scheduling process while ends with the due if any that needs to be collected for the healthcare services that were availed.

As the scheduling process of the patient is important, the organization shall be gathering the details as a part of data collection. This information can then be further used for filing the surname claims and even verify the eligibility or process the bills in near future. It is also important for the medical staff to make sure that patients have legitimate insurance that is available on paper so that the payment for the services can be made easily.

Best Practices for Revenue Cycle Management

  • To optimize the RCM, all major issues must be tackled well.
  • Encourage pre-registration during the appointment
  • Establish a patient’s account efficiently
  • Patient scheduling for an appointment be made conveniently
  • Maintain the medical history and insurance coverage of the patient
  • Derive more data that is accurate during the scheduling and registration phase

Revenue Cycle Management Challenges

There are different challenges of using such systems for healthcare. Some of them are:

  • Regularly evolving the guidelines of healthcare
  • Not easy to maintain a stable stream of revenue optimisation
  • Gather the payment within the certain time frame
  • Unable to get the reimbursement done quickly
  • Training the staff for reducing the risk of the error.

Advantages of Healthcare Revenue Cycle Management

Once the health care organization have the best revenue management, it can help to:

  • Track the billing and collection process in an efficient manner
  • Fill up the gap between the medical fees and accounting
  • Automate certain functions that need manual intervention earlier
  • Offer a single destination for the revenue collection process
  • Ease down all the communication using the accounting systems
  • Manage and preserve the past billing record in a proper manner

It is possible to prevent nearly 90% of the claim details. Besides, the preventive sorting out the payment can help to improve the finances in a significant manner and ease down different difficulties as well. That is why efficient revenue cycle management is needed in a healthcare organization.


Once all the medical services are available, it is time for the organization to start managing the past accounts if there were any, and even handle the accounts receivables in the right manner. It is important to handle the task efficiently with the help of revenue cycle management. This way whether it is the updating to be made on the patient’s account or managing tracks of uncollected patient records, now with such software, a better cycle can be maintained.

About Ambika Taylor

Myself Ambika Taylor. I am admin of For any business query, you can contact me at [email protected]