RCS is known as a vital module in the HIMS, and if this module is strong enough to manage and integrate with all you’re financial and accounts applications, then we can stamp this HIMS application.
What Is Revenue Cycle Solution (RCS) all about?
RCS is the financial process which facilities and manages the administrative and clinical functions associated with claims processing, payment, and revenue generation. The process includes identifying, managing, and collecting revenue for various hospital services.
Hospitals need to be successful in developing processes and policies to be financially healthy and RD assists in fulfilling this goal.
The process starts with the registration of the patient during the appointment of the medical services till the patient bill payments are settled either by a third party or self.
How useful it is to track in the hospitals?
The patient account is created by capturing medical history and insurance coverage during this process, this helps in understanding the demographics and eligibility for medical services. As the patient then travels to various departments of the hospital like OPD, laboratory, radiology, pharmacy and even so often visits the operation theatre for surgery or ICU for critical care, during this whole process, he avails the services which need to be documented and billed, which will be paid either by the insurance company or the patient himself, if this availed services and their charges are captured manually, there are good chances that capturing some services will be missed due to human errors which lead to revenue loss and leakages. With RCS, the entire patient journey will be well documented thus all the services will reflect on the bill, keeping a tight tab on revenue loss.
Generally, when hospital services are availed by the patient, the hospital needs to immediately raise a request to the respective insurance company for the claim process, but if the system is automated, then it becomes easy for the hospital employees to process and reduce the TAT (turn-around time) between providing a service and receiving payment by interacting with other health IT systems and medical billing systems.
All that the front desk has to do is to capture all the required data during the creation of the account, the rest of everything will be managed by the Revenue driver.
More often than not, insurance claims are denied by the insurance companies for trivial reasons. The management team then needs to investigate the cause of denials, it’s a very tedious job to be done manually, but with RCS, the deals and discounts offered to the standard schedule of charge can be monitored and analytical reports get generated by the software.
Thus, training the staff on the billing process and educating them about RCS will help the Hospitals to avoid claim denials. RCS flow check has proven a decrease of almost 23 % in claim denials.
Health IT and EHR systems have helped streamline and refine RCS management strategies. Many organizations use technology to track claims throughout their lifecycles, collect payments, and address claim denials. Ultimately, these technologies facilitate a steady stream of revenue.
Hospitals have been benefitted from RCS, facilitating smooth communication between payer and provider, monitoring the medical billing process, and scheduling hassle-free patient appointments
Conclusion:
RCS is a fundamental part of a healthcare organization’s attainment. It is difficult to do each component of patient management by yourself – that’s where Lifeline suite’s RCS module comes in.
Lifeline suite provides industry-leading revenue cycle solution. MIPL’S RCS module has helped dozens of healthcare systems achieve substantial growth in their medical billing and payment collections.
Our Lifeline suite’s RCS module focuses on giving world-class service, maximizing reimbursements, and delivering actionable insights into the financial health of your practice.
Hence, to attain an edge in the industry and to build a strong financial base Lifeline suite’s RCS module is your best friend.
Gouri Sardesai
Chief Information Officer
Manorama Infosolutions Pvt. Ltd.
