Simplifying patient experience on the front end, expediting back-end processes, and guaranteeing adherence to industry standards and best practices by combining the power of hyperautomation with significant knowledge and experience.

Revenue Cycle Management (RCM) forms the backbone of a profitable medical practice and plays a pivotal role in assuring the profitability and sustenance of any healthcare provider. Claim submissions account for $4.5 billion of the total healthcare spending in the US which is 13% of the entire administrative transactions.

Optimizing RCM is a key concern for healthcare providers to remain profitable, provide high-quality patient care, and deliver positive patient health outcomes.

The process starts from patient registration, billing, and medical coding to payment posting. Our solutions combine the power of hyperautomation combined with extensive expertise and experience to simplify the patient experience on the front end, streamline back-end operations, and ensure compliance with industry standards and best practices.

RCM Potential Opportunity Heatmap

RCM Potential Opportunity Heatmap

JK Tech’s End-to-End Solution for Revenue Cycle Management (RCM)

RCM FAQs

What is Revenue Cycle Management (RCM) in healthcare?

Revenue cycle management (RCM) in healthcare is a process in which healthcare providers undertake various claims, payments, and revenue generation functions. It comprises identifying, managing, and collecting patient service-related revenue. The financial process is crucial for the healthcare sector as it helps them in day-to-day activities related to administrative and clinical functions. RCM helps healthcare organizations to maintain profitability by increasing efficiency and reducing costs.

What are the stages involved in Healthcare RCM?

Due to the complexities in the operations of the healthcare sector, there are chances of errors at multiple levels. Thus, the Revenue Cycle Management system is divided into various steps.

  • Pre-authorization and Eligibility Verification – The initial process starts when a patient makes an appointment, the healthcare provider collects information to establish a patient account and collects the insurance information to verify their insurance eligibility. This reduces the chances of denied claims thereafter.
  • Charge Capturing and Coding – This is the process by which patients are billed according to the services availed using pre-accepted medical codes by which insurers determine reimbursement amounts. Without this step, the insurance company may deny the patient’s claim. It also costs the provider time and money as denied claims must be investigated and appealed.
  • Claims Submission – Once a patient’s treatment is concluded, the claim is sent to the insurance company for processing. RCM ensures the submission happens without any delay by tracking the claim from the start.
  • Payment Collections – Once the claim is approved, the insurance company reimburses the provider. If there is any remaining balance after the insurance reimbursement, the provider approaches the patient to collect the remaining amount. RCM expedites this by streamlining claims processing. Also, due to insurance eligibility verification, patients know from the start what out-of-pocket expenses they will have to incur.
  • Medical Service Review – RCM facilitates healthcare providers to analyze clinical treatment data which allows them to pinpoint steps where errors are being made and identify ways to lower their expenses. This eventually helps to increase revenue and improve the patient experience.

How can Hyperautomation improve RCM in Healthcare?

Although the RCM system is designed to offer convenience to Healthcare providers by easing operational efforts, the process can be improved with the advent of new technologies. Hyperautomation helps to increase the automation of various business functions. In RCM, Hyperautomation can prove to be a boon as it employs AI & Analytics, process mining, cognitive bot automation, AI rules engine, and Real-time analytics to prevent, detect and eliminate errors in the system. This is aimed to make the RCM more efficient in the long run.

How can JK Tech help to increase efficiency in Healthcare RCM?

JK Tech provides an end-to-end innovative RCM solution to identify and eliminate administrative inefficiencies in the healthcare processes and reducing costs, while increasing revenue and improving processes. We deliver the latest innovative solutions in the hyperautomation-enabled RCM space by collaborating with best-in-class solution partners in the ecosystem.


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