KDB’s Revenue Cycle Management specialists have over twenty years assisting solo and group physicians’ practices to maximize their revenue.

RCM is the financial process, utilizing medical billing software, that healthcare facilities use to track patient care episodes from registration and appointment scheduling to the final payment of a balance.

RCM is a critical component of a physician’s practice. Many small to medium size practices promote someone from within to be in charge of billing and collections. This may be a short-term solution, but oftentimes the process is incomplete and significant monies owed to the practice are outstanding.

Our RCM team focuses on all the administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue, according to the Healthcare Financial Management Association (HFMA).

Here is what’s involved in the RC:

  • Charge capture: Rendering medical services into billable charges
  • Claim submission: Submitting claims of billable fees to insurance companies
  • Coding: Properly coding diagnoses and procedures
  • Patient collections: Determining patient balances and collecting payments
  • Preregistration: Collecting preregistration information, such as insurance coverage, before a patient arrives for an inpatient or outpatient procedure
  • Registration: Collecting subsequent patient information during registration to establish a medical record number and meet various regulatory, financial, and clinical requirements
  • Remittance processing: Applying or rejecting payments through remittance processing
  • Third-party follow-up: Collecting payments from third-party insurers; and
  • Utilization review: Examining the necessity of medical services.