Purview Healthcare

How Is Medical Billing Services Different From Revenue Cycle Management

We were all struck down by the unimaginable impact of Covid-19. Most businesses felt the uncertainty in revenue generation more than ever. It’s safe to say that Healthcare has faced the highest repercussions. If you are in the Healthcare industry, you might still be juggling between mitigating the losses and carrying on with the usual process. This is where Revenue Cycle Management comes in. RCM is analysing, tracking and managing the status of your accounts receivables.

Difference between Medical Billing vs Revenue Cycle Management

Billing and revenue management are often confused with one another. But there are differences one needs to consider, especially if they are in the field of healthcare. Billing cycle services are a sub-part of Revenue cycle management.

Billing cycle services include submitting claims for services rendered to patients. After this is done, the next step is to follow up on these claims with the health insurance companies of these patients.

This is where the medical billing and coding cycle service ends. The rest of the management process is all about the Revenue cycle. RCM is much more than just managing pending bills, such as collections, compliance, Data analytics, Management Duties etc.

One more difference to the point is that RCM is a throughout the process, it starts as soon as a patient walks in for their appointment, however Billing cycle service starts only once the treatment is done and it’s time to clear the pending bills. Verifying insurance, collecting accurate demographics, entering charges, coding the treatment, creating and scrubbing claims, is a part of RCM but isn’t a part of billing cycle service.

How vital is Medical Billing in RCM?

Medical Billing service is the most important step in RCM. In fact, the complete RCM procedure depends on how effective the Medical Billing at any healthcare system is. As the Medical Billing process involves a third-party player, be it the insurance company or the patient, it becomes very vital for every step to be clear and the communication is clear.

Due to changing healthcare system, there is always some other new protocol that needs to be followed by the Medical Billing service. Many software companies have gotten into this business where they offer platforms that help the Medical Billing process be smoother. A lot of times, when the number of claims get very high and it becomes really difficult for the internal team to deal with such high demand for labour, they choose to outsource medical billing staff. This increases the efficiency of this particular step ultimately increasing the efficiency of the internal team in carrying out the rest of the RCM procedure just as smoothly.

This is why there are specific training courses given to Medical Billing executives. In fact, most managements have created this as a necessity in their internal procedure itself. Medical office staff can get certified through a variety of schools that offer specialised training and, in certain situations, a certification credential to represent professional status.

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