A Therapist’s Guide To Revenue Cycle Management (RCM)

Author: Paul Singh

To the frustration of many, the health care system has a lot of multi-word names and phrases thrown around, so it’s only natural to try and shorten these terms with initials. Therapists instantly know abbreviations like AMA (American Medical Association), CMS (Centers for Medicare and Medicaid Services), CPT (Current Procedural Terminology) and dozens, if not hundreds, of others. One that is currently rising in interest is RCM, which stands for Revenue Cycle Management, and it’s one that therapists need to understand.

The Healthcare Financial Management Association (HFMA, for those of you wanting even more initials) describes Revenue Cycle Management as “the process used by healthcare systems in the United States to track the revenue from patients, from their initial appointment or encounter with the healthcare system to their final payment of the balance. The cycle can be defined as, “all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue.” In other words, RCM is how practices handle the finances and processes associated with the different phases of patient care, from beginning to end. The cycle begins when a patient first schedules an appointment and proceeds through the therapy services provided to the billing afterward.

RCM has always been important to the lifeblood of a therapy practice, and with more regulatory oversight, thinner margins plus the demand for faster billing cycles, it’s becoming a make-or-break concern for many therapists.

Keeping up with the payer rules associated with the RCM process can be complex and challenging on its own. Claims can be rejected for a wide variety of reasons, ranging from not enough information, improper coding, compatibility issues as well as system errors. Obviously, claims that pass on their first attempt are vital to a good revenue cycle.

However, after therapy services have been provided, another critical medical billing RCM process crops up – managing past due patient accounts and accounts receivables. This can drastically affect your cash flow and ultimately determine the practice’s level of success. Too many outstanding collections can lead to bad debt. With a growing number of patients switching to high-deductible plans, more revenue is falling into delinquent accounts.

Far too often, practices are not equipped to manage collections properly. It’s not a fun task and many can’t afford the time and labor involved to track down the collections. Few staff members are ever properly trained in debt collections. Far too often, overdue claims are not even reviewed. Some decide to write off the bad debt as a loss. That’s like TMA (throwing money away).

Therapists are faced with a dilemma – dedicate their resources toward revenue cycle management or devote that same time and energy to healing their patients. Trying to efficiently and effectively managing the different phases of RCM can be an overwhelming challenge to most practices. How then, can a practice successfully keep their RCM running smoothly while continually focusing on their patients’ needs?

StratPT is a solution to a therapy practice’s entire revenue cycle management, offering a powerful all-in-one-solution. We offer unequaled billing, insurance credentialing and benefit verification services that seamlessly integrate with our user-friendly scheduling, documentation and practice management software. With an unmatched level of customer service, we continue to have the #1 accounts receivable collection rates in the entire industry.

Our priority is your practice. Family-owned and operated, and utilizing a uniquely personal approach, we listen to each client’s individual concerns. Our business has grown because we treat everyone like family and wholeheartedly care about the success of your business.

We are here to help. Contact us today to see how we can make you RCM a POC (piece of cake).

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