Clover has powered revenue intelligence for hundreds of healthcare businesses, from small clinics to large health systems.

Cyclicity of Revenue in Healthcare

Revenue Cycle in healthcare entails entails identification, collection, and management of payments from patients and payors for services rendered. By convention, it comprises of activities such as patient pre-authorization, claims submission by provider, eligibility and benefits verification by payor, payment posting, denial management and reporting.

Patient management and care delivery is an on-going process, with new payment requests and claims getting captured every day. However, healthcare providers track the financial health of their practice by reviewing their operations against the revenue generated over a period of time. This makes revenue management a cyclic process that needs repeated monitoring.

Benefits of RCM Automation

RCM is essentially an internal process which healthcare providers prefer managing on their own, largely due to the sensitive nature of data. However, there are several revenue cycle management software solutions and products available in the market, that allow providers to automate their RCM process.

For practices with thousands of practitioners and multiple operating locations, RCM automation becomes a necessity otherwise the administrative load can become crippling and regressive for the organization. Many even prefer outsourcing the process to achieve efficiency and better financial success.

RCM automation, internal or outsourced, essentially helps providers dedicate their focus back on patient care and allow trained professionals to handle revenue management. Critical areas that benefit from RCM automation are operational costs management, resource allocation, data compliance, authorization, regulations, billing, and payor contract management.

Ultimately, with automated RCM, the practice gets paid to its fullest potential – be it from the patients or payors.