Revenue Cycle Management Solutions
Increase cash flow with revenue cycle management solutions spanning the entire patient lifecycle
Speed your time to reimbursement
With consumer out-of-pocket spending on the rise and reimbursement structures becoming more complex, manual processes are slowing organizations down and costing them revenue.
The fix? Automated and data-driven insights across the revenue cycle, from patient access to collections management.
- Secure better access for patients
- Stop manually processing claims
- Increase collections and cash flow
- Stay compliant while providing an elevated patient experience
2024 #1 Best in KLAS
Claims Management and Clearinghouse
2024 #1 Best in KLAS
Revenue Cycle - Contract Management
BlackBook 2024 Top Client-rated Financial Solution
Denial and Claims Management Outsourcing, Health Systems
2023 #1 Best in KLAS ranking
Claims Management and Clearinghouse
2023 #1 Best in KLAS
Revenue Cycle - Contract Management
BlackBook 2022 Top Client-rated Financial Solution
Hospital Claims Management Systems
BlackBook 2021 Top Client-rated Financial Solution
Hospital Claims Management Systems & Patient Identifier Solutions
2020 KLAS Category Leader
Contract Management
Patient Access Solutions
Strengthen your revenue cycle process by ensuring correct patient information on the front end, reducing errors that cause rework in the back office.
Healthcare Collections
Optimize collections and recovery rates on past-due accounts while decreasing your cost to collect.
Healthcare Claims Management
Our integrated products automate your claims workflows and improve your healthcare claims management process.
Payer Contract Management
Missed payer payments and underpayments add stress and uncertainty to your revenue cycle. Audit payer compliance against contract terms for maximum revenue.
2,700
Payer connections
$4.9B
Annual collections facilitated
175M
Annual claims processed
3.2B +
Annual eligibility transactions
Stanford Health Care
Hear how Stanford’s Operations team uses Collections Optimization Manager to reduce their cost to collect and automate bad debt assignments, charitable write-offs, and more.
Essentia Health
How Essentia Health used Coverage Discovery to find 67% coverage for patient accounts that were self-pay or uninsured at the point of pre-service.
The State of Patient Access 2024
The latest survey results of 200 healthcare employees and 1,036 patients/guardians, examined the perspectives on their perceptions of access to healthcare:
- 49% of providers say patient information errors are a main reason for denied claims.
- Patients who felt access improved rose by 11% points; providers saw a 28% point increase.
Frequently Asked Questions (FAQs)
Browse these revenue management in healthcare FAQs. Learn how to improve revenue cycle management.
Revenue management in healthcare connects the financial and clinical aspects of care. Its purpose is to ensure proper reimbursement and accurate, efficient billings and claims management processes.
Revenue cycle components include:
Patient registration
Eligibility and benefits review
Data entry of patient information
Prior authorization requests
Patient encounters for treatment and services
Charge posting documentation
Coding and billing of claims
Claims management
Payer contract management
Patient billing and collections
Healthcare revenue cycle analytics leverages data to analyze, track and optimize healthcare revenue cycle management (RCM). Its benefits include insight into performance, identifying revenue leakage, payer response and KPI monitoring. It’s a business intelligence tool focusing on problem areas of billing efficiency, reimbursements, benchmarking and trending historical data.
Revenue cycle optimization is possible with many strategies. Healthcare revenue cycle optimization is achievable by:
Staying updated on payer policies with automated alerts
Enhancing patient access
Using technology that automates processes and streamlines the workflow
Improving patient matching to reduce denials
Collecting and acting on actionable insights from RCM analytics
These tips can improve reimbursement efficiency:
Create a streamlined verification process.
Provide patient estimates for upfront collections.
Integrate document review processes to reduce denials.
Use artificial intelligence (AI) and machine learning for claims verification.
Make corrections to denials quickly for resubmittal.
5 strategies on how to increase outpatient revenue
Patients want a better experience at every step of the patient journey. They want to see their doctor faster, manage appointments online and understand how much it costs—with as little red tape as possible.
Revenue cycle management best practices: a guide for success
Maintaining a healthy cash flow is the only way to deliver quality patient care, invest in state-of-the-art technologies and keep daily operations running smoothly.
The future of revenue cycle management: 12 trends to watch
In healthcare revenue cycle management (RCM), the mantra is clear: maximize revenue and minimize costs. It’s more complex in practice, requiring RCM leaders to anticipate and adapt to whatever’s around the corner.
What is revenue cycle management in healthcare?
As economists offer up their best guesses for the US economy over the coming year, healthcare leaders know one thing for sure: no matter what happens, they need solid revenue cycle management (RCM) processes to remain financially sound and deliver high-quality care.