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Revenue Cycle Management: Medical Billing Vs. Accounting

Your holistic practice’s longevity and financial success depends on how efficiently and effectively you can manage your revenue cycle.

Without ensuring this key component of your strategy is running smoothly, you’ll be struggling to keep your practice in the green.

A comprehensive revenue cycle management strategy can really transform your holistic practice and help chart the course of your practice’s future. But what exactly is a revenue cycle and how do terms like accounting or medical billing factor in?

We’ll break it down in this article; keep reading to learn more!

What Is Revenue Cycle Management?

In the most general definition, revenue cycle management, sometimes shortened to RCM, encompasses the identification, collection, and management of a practice’s finances based on the services rendered. 

In other words, RCM refers to the processes required to manage and streamline the various components of a holistic practice’s financial standing.

The typical steps of a practice’s revenue cycle are as follows:

  • Patient registration and scheduling
  • Prior authorizations and eligibility verification
  • Patient visit and treatment
  • Documentation
  • Charge capture and charge entry
  • Medical coding
  • Medical claim submission
  • Payment posting or denial
  • If claims are rejected, rework and resubmit until you get the money owed

A frequently asked question regarding RCM: who exactly is involved in the revenue cycle at your holistic practice? The short answer is everyone!

This includes your

  • Patients
  • Payers, whether it’s insurance companies or government programs
  • Staff

Anything to do with the financial side of your holistic practice is, obviously, vital for its long-term presence in your community and your ability to scale up in the future. 

For instance, effectively managing rejected claims and establishing processes that address errors in your claims is a foundational step to optimizing your overall revenue cycle management strategy. 

What's the Difference Between Medical Billing and Healthcare Accounting?

Since there are so many facets of the healthcare revenue cycle, it’s easy to use other financial terms interchangeably. Take medical billing and accounting—what do these two concepts actually mean and how do they relate to your holistic practice’s RCM?

Let’s break them down here:

Medical Billing

Medical billing is the process of translating a patient’s delivery of care into a financial representation so that your practice can be reimbursed for services rendered. 

This process involves medical billing codes and submitting claims to insurance companies, Medicare, the VA, or whatever other payer programs relevant to your patients, so that you can receive money from them for the services you provided.

Healthcare Accounting

On the flipside, healthcare accounting is the practice of processing and recording financial transactions; basically, what you do in your personal finances but perhaps with a few more figures thrown into the mix.

Healthcare accounting includes a few different standards for performance, such as accounts receivable and accounts payable, which are two metrics that are vital to benchmarking your holistic practice’s financial health.

Effective Revenue Cycle Management Depends on Accurate Medical Billing

As the old adage goes, time is money. Nowhere is that truer than in the case of your holistic practice’s revenue cycle! Ensuring your medical billing process is streamlined and as accurate as possible might take some time and effort to establish but will bring tremendous benefits to your practice. 

A streamlined medical billing and coding process means you’re only working each of your claims once and submitting them promptly so that you can get paid in a timely manner! Reworking claims happens to the best of us, but should be the exception, not the rule.

The sooner you can minimize bottlenecks and clunky medical billing processes, the better off your practice will be!

Partner with Holistic Billing Services to Optimize Your Revenue Cycle!

Partnering with a medical billing firm to handle your medical billing can radically transform your holistic practice’s revenue cycle.

A trusted firm can empower your practice with comprehensive reporting and can act as an in-house expert for all your revenue cycle needs. With the medical billing burden off your shoulders, you can focus on what matters most: delivering quality care to your patients.

With the friendly experts at Holistic Billing Services, you’ll have decades of experience by your side who can help navigate the worlds of medical billing, healthcare software, and more! Ready to optimize your revenue cycle? 

Contact us today to get started!

October 28, 2022
 - by Antonio Arias, MBA, CHBME
Medical Coding Bill And Billing Codes Spreadsheets
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