Revenue
Collects patients' names, contact details, and insurance information at the start.
What is Registration?
Fixes and appeals rejected insurance claims to cover lost revenue.
What is Denial Management?
Gathers patient details, demographic, and personal medical history when an appointment is booked.
What is Patient Scheduling and Registration?
Checks insurance eligibility and benefits before care to see what the plan covers.
What is Verification?
What is Patient Billing?
Confirms active insurance coverage, calculates out-of-pocket cost, and checks for prior authorization needs.
What is Insurance Verification and Elgibility?
Applies money received from insurance companies to the correct account.
What is Payment posting?
What are the three pillars of Revenue Cycle Management?
What are People, Processes, and Technology?
Translated clinical care notes into standard numerical medical codes (CPT and ICS-10).
What is Charge Capture and Medical Coding?
What is the difference between medical billing and RCM?
Medical billing is a tactical process focused on submitting and tracking individual claims, whereas Revenue Cycle Management, is a broad strategic system covering the entire financial journey from first appointment to final payment.
What are common RCM mistakes?
Transmits finalized, clean claims electronically to insurance payers for payments.
What is Claims Submission?
The financial process that tracks a patient's journey from scheduling an appointment to the final payment resolution.
What is RCM?
What are the 4 Ps of the Revenue Cycle Management?
What is Patient, Provider, Payer and Process?
Sends final statements to patients for remaining balances like copays and deductibles.
What is Patient Billing and Collections?