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• Healthcare IT
• U.S. Revenue Cycle Management Market

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U.S. Revenue Cycle Management Market Size, Share & COVID-19 Impact Analysis, By Structure (In-house and Outsourced), By Type (Software and Services), By Function (Claims & Denial Management, Medical Coding & Billing, Clinical Documentation Improvement (CDI), Insurance, and Others), By End-User (Hospitals, Physician’s Office, and Others), and Country Forecast, 2023-2030

Last Updated: June 24, 2024 | Format: PDF | Report ID: FBI108765

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KEY MARKET INSIGHTS

The U.S. revenue cycle management market size was worth USD 64.13 billion in 2022 and is projected to grow at a CAGR of 10.7% during the forecast period.

Revenue cycle management (RCM) is a healthcare process implemented to maintain a complete record of patient expenses from admissions to discharge. This process streamlines the business operations of healthcare organizations. It facilitates various functions, such as patient insurance eligibility verification, medical coding & billing, clinical documentation, electronic health records , and claims & denials management.

The increasing need for process improvement in healthcare systems, revenue loss due to billing errors, and growing government funding to boost the adoption of revenue cycle management solutions are a few factors driving the U.S. revenue cycle management market share.

However, in 2020, the market was negatively affected due to a significant loss of operating revenue in healthcare settings. Furthermore, a decrease in non-COVID-19 patients was observed in healthcare settings, impacting the market growth.

LATEST TRENDS

Shift Toward Outsourcing Revenue Cycle Management for Financial Performance Improvement Drives Market Growth

Rapid surges in-patient admissions and increasing complications during operating revenue management in healthcare settings are accelerating the adoption of revenue cycle management . However, the shift toward an outsourcing model provides significant benefits compared to the in-house model in medical billing & coding, managing claim denials, and others.

Moreover, implementing machine intelligence is a cost-effective way to reduce errors in the outsourcing model compared to the in-house model. For instance, according to the data published by Change Healthcare in 2022, 98% of U.S. hospitals will be using artificial intelligence across the revenue cycle by the end of 2023. These benefits help healthcare facilities to adopt the outsourcing model.

DRIVING FACTORS

Growing Need to Manage Unstructured Healthcare Data Aids the Market Growth

In the healthcare industry, the volume of data produced has expanded to terabytes and petabytes, mainly due to rising patient volumes and the digitalization of financial information. For instance, according to the data published by the American Hospital Association in 2023, there were around 33,356,853 admissions in U.S. hospitals in 2022, which increased to 34,011,386 in 2023. This creates a vital need for using revenue cycle management solutions.

In addition, the sheer diversity of data in healthcare and the growing usage and prominence of healthcare information technology tools are other significant factors contributing to the U.S. revenue cycle management market growth.

RESTRAINING FACTORS

Rising Security Concerns to Restrain Market Growth

The increased use of automated technologies, such as electronic healthcare records (EHRs), offers greater reach and healthcare delivery but has high-security concerns. However, the security concern regarding protecting patients’ confidential data limits the market's growth. For instance, in the U.S., the cost of data breaches in healthcare increased by 25.5% in 2021 to USD 9.23 million from USD 7.13 million in 2020, according to a report by Binary Stream Software Inc. These interruptions are hampering the adoption rate in the market in the country.

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The number of U.S. hospitals increased from 6,093 in 2022 to 6,129 in 2023.

SEGMENTATION

By structure analysis.

Based on the structure, the market is divided into outsourced and in-house.

The in-house segment dominated the market in terms of revenue in 2022 owing to rapid growth in the number of patient admissions supporting the in-house model's adoption rate. For instance, per the data published by the American Hospital Association (AHA) survey, nearly 33.0 million hospital admissions were registered in 2021.

Furthermore, the outsourced segment is projected to grow at the fastest CAGR over the forecast period owing to the shift from in-house models to outsourcing models in nations, including the U.S., India, Germany, the U.K., and others.

By Type Analysis

Based on type, this market is classified into services and software.

The software segment held a larger share in 2022 due to the launch of advanced software to improve efficiency for healthcare providers and payers. Furthermore, the growing need to manage unstructured healthcare data due to increasing patient volume also influences segmental growth.

• For instance, in September 2022, Advata, Inc., an analytics software company, launched Advata Smart AR, a new revenue cycle management product to improve staff experience and productivity in healthcare.

In addition, the services segment is projected to grow fastest during the projected period. The demand for RCM services, such as outsourcing, medical coding, billing services, and others is growing due to certain advantages, including an active focus on quality patient care, decreased coding and billing errors, and timely reimbursement. Hence, due to the abovementioned factors, the segment is projected to have the fastest growth rate.

By Function Analysis

Based on function, this market is classified into claims & denial management, clinical documentation improvement (CDI), medical coding & billing, insurance, and others.

The claims & denial management segment accounted for a highest U.S. revenue cycle management market share due to the introduction of advanced solutions to reduce claims rejections.

• For instance, in October 2021, Dolbey launched Fusion Reclaim, a denial management module for their healthcare revenue cycle solutions, to assist and track the denial process.

Moreover, the medical coding & billing segment accounted for the second-highest market share in 2022 and is projected to maintain its position over the forecast period. Financial management complexities associated with the end-users are projected to drive the demand for medical codes and billing services.

By End User Analysis

Based on end user, this market is segmented into hospitals, physician’s office, and others.

The hospitals segment held a larger share in 2022 owing to the increasing patient admissions, generating higher revenue for hospitals. Furthermore, the higher market share is mainly attributed to the effective RCM processes and technologies that provide healthcare providers with streamlined workflows, improved financial performance, and a better overall patient experience.

Moreover, the physician’s office segment is expected to grow fastest during the forecast period.  The gradual rise in the number of physicians in the country fosters the market adoption rate and supports this segment's growth.

KEY INDUSTRY PLAYERS

Regarding the competitive landscape, the U.S. revenue cycle management market is fragmented with several key players including Epic Systems Corporation, Optum Inc., R1 RCM, Inc., and others. In 2022, Epic Systems Corporation accounted for the highest revenue share in the market, owing to the adoption of EHR and RCM systems in its product portfolio. Moreover, the company provides end-to-end services focusing on production, efficiency, and budget needs.

Some other companies operating in the market are Cerner Corporation, Allscripts Healthcare, LLC, Conifer Health Solutions, LLC, Medical Information Technology, Inc. (MEDITECH), MEDHOST, GeBBS Healthcare Solutions, Inc., Optum Inc., McKesson Corporation, and R1 RCM, Inc.

LIST OF KEY COMPANIES PROFILED:

• Allscripts Healthcare, LLC (Veradigm LLC) (U.S.)
• Cerner Corporation (U.S.)
• Conifer Health Solutions, LLC (U.S)
• Epic Systems Corporation (U.S)
• GeBBS Healthcare Solutions (U.S)
• MEDHOST (U.S)
• McKesson Corporation (U.S)
• Medical Information Technology, Inc. (MEDITECH) (U.S)
• Optum Inc. (U.S.)
• R1 RCM, Inc. (U.S.)

KEY INDUSTRY DEVELOPMENTS:

• May 2023 – TA Associates Management, LP, a private equity firm, signed a definitive agreement to invest in Alpha II, LLC, a leading provider of RCM technology solutions to healthcare providers. The investment supports Alpha II’s expansion of revenue cycle management software solutions.
• October 2022 – Inovalon, a cloud-based software solutions provider, launched RCM Intelligence to improve the quality and performance of claims processing.
• October 2022 – NYM, a leader in information technology services, announced the expansion of its product portfolio by offering its medical coding engine to radiology departments across the U.S.

REPORT COVERAGE

An Infographic Representation of U.S. Revenue Cycle Management Market

To get information on various segments, share your queries with us

The U.S. revenue cycle management market report provides a detailed analysis of the market. It focuses on key aspects such as a statistical overview of hospital admissions and new product launches.  Additionally, it includes key industry developments such as mergers, partnerships, & acquisitions and the impact of COVID-19 pandemic on the market. Besides this, the report also offers insights into the market trends and highlights key industry dynamics. In addition to the aforementioned factors, it encompasses several factors that have contributed to the growth of the market over recent years.

Report Scope & Segmentation

Frequently Asked Questions

Fortune Business Insights says the U.S. market was worth USD 64.13 billion in 2022.

The market is expected to exhibit a CAGR of 10.7% during the forecast period (2023-2030).

By structure, in-house accounted for the leading share of the market.

Epic Systems Corporation, Cerner Corporation, and R1 RCM, Inc. are the top players in the market.

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• STUDY PERIOD: 2019-2030
• BASE YEAR: 2022
• HISTORICAL DATA: 2019-2021
• NO OF PAGES: 80

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The U.S. revenue cycle management market size was worth USD 64.13 billion in 2022 and is projected to grow at a CAGR of 10.7% during the forecast period

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Essential RCM Trends for 2022 and Beyond

Times have changed, and the aspects that could bring in some momentum to the revenue cycle market has radically shifted to automation, technology, patient engagement, recuperation, and such. And post COVID-19 pandemic, this impact was expanded largely throughout hospitals and healthcare sectors.

Hospitals are currently functioning on critically tight revenue margins which has made it crucial for them to attain maximum out of the revenue stream. This situation brings about the efficiency of technology and innovations to the light, allowing revenue cycle managers to enhance the business outcomes.

Let us look into major trends in Revenue Cycle Management that have booked their place in the market for the longer run.

Table of Contents

Prior-Authorization and eligibility verification

Conventional healthcare systems lagged in the information exchange for updating insurance eligibility verification and prior authorization of patients. These are crucial steps to attain standardized documentation. With clearing houses into the picture, the modernized information exchange is emerging through API-driven advancements.

Patient Experience and Access

Patients must have quick and easy access to information regarding their treatment, co-pay and co-insurance requirements, the corresponding charges covered by their insurance payer; one of the major issues prevailing in the healthcare system to upgrading the services and patient experience.

With the emergence of new technologies, these challenges can be easily handled. Information on patient demographics, out-of-the pocket charges, co-insurances, insurance coverage, and payment plans through an Omni-channel information system, facilitating an enhanced patient experience for the longer run.

Efficient Front End

Front-end office is the first step for patients as they go into any practice. That’s where information gathering happens and most revenue managers understand the importance of a streamlined front-end office. All the issues regarding the RCM cycle must be rectified within the front-end office rather than stretching them to the back-end and addressing them later.

The front-end operations include prior-authorization , patient registration, patient demographics, and collection of co-pays. The seamless improvement in these functionalities will effectively accelerate clinical documentation, revenue integrity, and denial management.

Automated Coding

The digital era is all about technology that doesn’t require any human involvement. The adoption of such technologies has been increasing at large in the past few decades. Not just that, the incorporation of advancements such as Machine Learning, Artificial Intelligence, Robotic Process Automation, and such will radically reduce the manpower costs.

Medical coding is one such area that is getting increased attention of technologies for standardization. Combining technology and coding will put off a huge burden for revenue cycle staff , thereby arresting huge levels of revenue leakages.

Telehealth Facility

Rooted from the emergence of the pandemic, telehealth has been a great hit. It delivers best patient care on an online platform without compromising on the quality of services provided. It significantly reduces cost for patient care and incorporates processes that can help boost the entire revenue cycle.

Accounts Receivables, Denials, and Prevention

Now that AR status has shifted from calls to portals, revenue streams are seen gaining a positive momentum. The relevancy of Chatbots using conversational AI has found its way into the filing for denials. Customizations of denial appeal files is another practice that is determined to stay for the long run for its increased efficiency.

Another aspect that has proven its efficiency for denial prevention is the ability of technology to identify prevalent issues in denials, find the root cause, and come up with solutions to rectify the same.

Underpayment issues

Revenue cycle process for hospitals and practices are bombarded with underpayment issues. These issues reflect negatively to the revenue streams, resulting in major revenue leakage. And that is why performance analytics has come for the rescue. It brings about actionable insights on the performance that are critical for businesses to function. The standardized KPIs brought in by the analytics helps enable precise performance updates and corrective actions if needed.

Working Remotely

During the pandemic outbreak, companies had declared work from home option for employees to adapt to the situation and at the same time keep the businesses stable. This model was necessitated as the situation demanded frequent lockdowns. But this also put revenue cycle managers on the line to find and implement technologies to monitor the RCM performances and manage the processes. However, the post-pandemic climate also prefers remote working due to the radical growth in the RCM workforce and efficiency in processing.

Involvement of Private Equities

There has been evidently a significant rise in the role of private equity in the healthcare sector . They bring in strategic plans and investments to restructure the already existing business and help them enhance their revenue streams. Most of the private equity investments are technology-led. In healthcare, the major investments are on improving patient experience, prior authorization, eligibility verification, credentialing , automated coding, and on large-scale offshore firms.

Provider Consolidation

With increased instances of provider consolidation, there is a subsequent rise in investments in areas including behavioural/mental health , wellness-centric treatments, urgent cares, home healthcare. This trend is expected to continue for some time as it has had a great impact on the practice revenue streams.

Manpower Shortage and Outsourcing

One of the major issues that prevails in the healthcare sector is the manpower shortage . This limitation in RCM processing has led practices to a systematic approach of outsourcing. This not only reduces the staff shortage and manpower expenses, but helps to bring in RCM expertise with proficient knowledge in the entire RCM cycle.

The past two years had been really crucial for healthcare sector in terms of business transformation. Year 2022 has brought together these drastic changes and set a path for the future years to follow. This year has pushed staff from all industries to think innovatively and build strategies for feasible frameworks, allowing revenue cycle staff to create flexible revenue cycle processes.

We at Practolytics keep a vigil on the latest industry trends and ensure our clients are on top of it to ensure all new innovations and technologies are adapted wherever necessary.  Talk to our experts to understand more about the emerging trends in the Healthcare Revenue Cycle arena.

ALSO READ – Top 9 KPIs for Effective Revenue Cycle Management

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Top 4 Things To Consider For Your RCM Operations In 2022

Read Time: 2 Min

Revenue cycle goals for many leaders are aggressive, but may not be totally realistic with their current operations.

According to a study produced by TransUnion Healthcare on January 27, 2021 – “rising unemployment and income loss, will continue to play a major role in health insurance coverage disruptions across the nation.”

Protection of the revenue that has returned for your operations since the pandemic disruption becomes tantamount to success of business operations. Cash realization is what makes the engine run.

With these challenges, here are 4 areas to provide focus for your RCM leaders to make sure financial outcomes are met, and barriers to success are addressed quickly and appropriately.

1. Pressure on Upfront Processes

One example we can give, is  patient authorization forms , where payors are getting significantly more aggressive on patient authorizations. As we know, payors are already constantly placing barriers for providers to overcome prior to achieving their entitled reimbursement. Now, two to pay particular attention to are Aetna and Cigna plans. Both insurers, who according to BeckersASC.com, has over 42.5 million members, have required further patient participation in the appeals process before providers can initiate any action.

The change became effective January 1, 2021, and requires that the provider have the patient complete a form created by each payer, that gives the provider the authority to act as proxy for a multitude of revenue cycle related actions. CRx recommends that if your patients have either of these payers as their carriers, that your admission package include these forms for their completion. The form should be reviewed with a financial counselor as there are areas that are confusing, and work against the provider that should be managed if at all possible.

Another example of this is regulatory activity & up-to-date insurance coverage changes. We have read and sometimes seen In and Out of Network Cost Sharing Waivers given by health insurers.

The forgiveness has included Covid-19 related testing and encounters, Inpatient out of pocket adjusted for Covid-19 related admissions, and Telehealth visits and early refills on prescription medicine patient share discounts have been passed on to consumers also.

However there has been confusion at times as there are many incidents of patients getting billed for the services mentioned above also. There are reports documented in the media citing financial ruin because of Covid related expenses, despite the CARES Act and what payers have stated. Each facility has a moral obligation to consider if and when to apply forgiveness for your patient.

Then we have Surprise Billing Legislation – Providers affected by this legislation should be evaluating its impact on its front end operations to prepare for process change the back half of the calendar year.

Develop process flow around how your billing will comply with the legislation

Discuss the process with your business partners to include hospitals, ASCs etc.

Establish policies and procedures to comply

2. Service Offerings Affecting Cash Collections

Many of our clients have experienced a shift in the types of services they provide for their patient clientele. Patients who may have once decided to fix a health issue with one, maybe two surgeries for a practice are now managing their issue through evaluation and management and telehealth visits. How does this affect your cash expectations?

Kaiser Permanente states that by June 2020, 30% of all outpatient visits nationally we be performed via telemedicine.   The insurance giant utilization of the telehealth was used 90% of the time for its appointments during the height of the pandemic, compared to 26% during the same time the previous year. They accomplish this without reducing access to care for its connected patients. They also stated that they believe the US companies could save $6 billion a year with more investment.

Practices and businesses should begin to examine how this shift is and will influence their financial outlook moving forward. As services shift to more outpatient management, and less face-to-face treatment, does that increase or lower your cash expectation? How will such a movement change your staffing needs? Is your operation equipped with the appropriate technology to provide telemedicine as a service?

3. Rise of Technology supporting RCM

With the need to support staff who are mostly working from home in today’s environment, the need for efficiency and technology support will be a priority for collection efforts made in 2022-2023. In particular, workflow optimization is an essential component. Understanding workflow is critical because the most common issues on the back end of collections are caused by breakdowns in the early parts of the revenue cycle , like clinical denials or incorrect 837 data. We’ve automated AR workflow by identifying “at-risk” accounts so an FTE doesn’t have to spend the time doing so. Second is data reconciliation. One of our strongest procedures to optimize revenue is our in-depth reconciliation processes throughout collections. We found that when we follow behind another billing company or inhouse billing, there are many missed encounters which can lead to 5-10% missed revenue in AR follow up alone. So we’ve put multiple checks in place to ensure that every single claim has been followed up on, processed by the insurance company, and there is money in the bank. Here’s an example of a common mistake made by many providers when they are not taking the time to capture each encounter accurately and failing to reconcile billed claims to payment.

In this example, the provider billed 20 encounters and 17 of them were successfully processed by the insurance company. But because the provider did not diligently follow up, the other 3 encounters were never processed by the insurance company. If each of these encounters were worth $3,000, this would result in $9,000 of missed revenue just that day. Now think if this error occurred every day, it could result in a $180,000 loss of revenue throughout the entire month!

The point is, even missing only one charge per day can add up to significant dollars lost in the long term.

4. Getting Paid Fairly, Accurately, & On-Time

Do you know if you are getting paid correctly? If that answer is anything but a confident YES, then chances are your facility is leaving money on the table. One of the most important imperatives of any RCM operation is to have targets through the cycle to meet and or exceed. The most important from a financial perspective in that tracking is cash receipts. Understanding what your team should collect based on the revenue produced tells executives whether the performance has been good enough or not. Having static goals unrelated to revenue produced creates tension in some cases where none is called for, and celebration in other instances where team members should be checking for issues blocking cash. Knowledge is power. Know what to collect based on the revenue your operation produced.

Additionally, here are some key metrics and reports that are more important than ever before to monitor to ensure you are able to collect the highest possible reimbursements from payors.

• Patient volume Report – are you open, do you have a business, what type of marketing do you need to doing?
• Patient Responsibility Report – do you have up-to-date rules on co-pays? Are rule out procedures part of out-of-pocket, or not?
• Backlogs exist? – related to covid, staffing shortages, visit growth?
• Billing Report – charges out and reconciliation
• Coding reports – that no backlogs are building
• Telemedicine – how are you being paid? By payor? By CPT code?
• Keep in mind:  With up to a 22% denial rate this year, oftentimes they are resolvable by a phone call, but you have to know why they’re happening to fix the issues. Understanding your denials by payor, procedure and CPT code allow you to analyze why you’re having denials and put a game plan in place to remedy.

We know revenue cycle is a tedious but necessary process in healthcare, especially when dealing with hundreds, if not thousands of claims. PM systems are great at billing out claims, but you need an integrated workflow tool in order to effectively manage the process & collections of claims. We deliver confidence and certainty in the performance of your revenue cycle with technology , automation, and strategic management.

If you’re ready to optimize your workflow, contact us!

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How To Build a Successful RCM Business Plan

If you’re looking for an opportunity to make a difference at work and in your community, RCM can help!

India is a country with more than 130 crore people, who are the potential customers for any product. It has a population that is young and hungry for development.

RCM is India’s largest direct selling company with a network of 10 million direct selling partners, like you.

The article will cover the basics of how to build a successful RCM business.

Table of Contents

What Is RCM Business

The Indian Direct Selling market is at the cusp of exciting growth. The year 2016 has seen unprecedented success for direct selling companies with a total turnover of Rs 10,000 crore and over 3 million distributors in the country.

• RCM is a business that helps physicians with their medical billing and coding. This industry has been growing steadily in recent years, with an estimated annual growth rate of 12%.
• There are many reasons for this growth, such as the more stringent requirements for electronic medical records (EMRs) and Meaningful Use Stage 2 guidelines.
• Other factors include increasing patient awareness about online resources and an increased interest in preventative care.
• It is not easy getting started on RCM because there are no entry barrier risks compared to other businesses out there. However,
• it requires persistence, patience, and dedication among others. On top of all these challenges, the competition in this space is stiff compared to other industries.

Who Should Try RCM?

①. Physicians /Doctors/Dentists – They have spent years studying and practicing medicine and it would be great to give back to society by helping them bill their procedures.

②. Medical Coders – Working as Coding Assistant or Associate Medical Biller are two common careers. But most people don’t know what they get paid for this profession.

③. HealthCare M&A Professionals – There are several health care professionals out there who could use some extra money. For example nurses, pharmacists, physical therapists, nutritionists, medical assistants, or even dentists.

④. Healthcare Organizations Partner Investors – RCM gives health care investors access to a new revenue stream of healthcare staffing products and solutions. You can also invest in other healthcare-related businesses that directly impact public health.

⑤. Entrepreneurs – In addition to making healthy living choices, we also support entrepreneurs with innovative ideas. We pay up to 70% commission on every sale generated by our sellers. So if someone wants an idea to turn into a business, that’s a win-win situation for everyone involved.

⑥. Students – People continue their education past high school and college graduation. Many of them are interested in becoming doctors but lack the funds to go to med school. Being able to help them make ends meet is another form of giving back to society.

⑦. Veterans – More than 50% of veterans face post-traumatic stress disorder. Many veterans have experienced a lifetime of trauma and the government programs might not be enough for them to live comfortably.

Helping them become independent again through work is one way to give back. Because of these seven reasons, people like to use them and that’s why we can start this business.

How to Build a Successful RCM Business

• The first step is to create a plan that outlines your long-term goals in detail.
• Next, you will need to find potential clients and figure out which industries they’re working in.
• Then, it’s time to start building relationships with influential people in the industry to get them on board with your idea.
• Once you’ve made some progress, you want to set up meetings with key players in the industry and go into detail about how your idea can benefit them.
• Lastly, it’s important to measure and track how well your plan is going.

RCM is a very competitive industry so it takes hard work, perseverance, and commitment to succeed.

The best thing to do once you try our business model is to take notes on everything you learn. That way when you come back, you’ll already have the experience to build upon.

If you’re thinking about starting your own business, I highly recommend you check out my course because I have built something similar in the past. Feel free to reach out to me anytime!

What Our Customers say…

“I am a nurse at a local hospital and I wanted to build income outside the workplace. I had heard of Rachael before and knew she”

Benefits of Being an RCM Business Partner

RCM partnerships are the key to success for many local businesses. If you’re in the market and looking for a new opportunity, it’s worth exploring your options as an RCM partner.

RCM partners offer a huge network of customers who have already expressed interest in what you have to offer.

This means that you don’t need to spend money advertising or Marketing yourself; instead, your business name and logo appear right next to other RCM partners’ names and logos.

These customers will contact your business for products and Revenue Cycle services Business, just as they would any other RCM business plan owner. To sum things up,

There are five benefits of being an RCM Business partnership.

• You’ll earn cash flow from sales
• You’ll generate more leads
• Your business will grow
• Customers trust you
• You’ll look great on social media platforms 

How to Start Your Own RCM Business Products List

The last decade has seen massive growth in online education thanks to companies like Coursera, Udemy, and edX. However, not all online courses are created equal. Some are high quality while others aren’t.

✔ The goal of this video is to demystify the process of creating a high-quality course on YouTube (or anywhere else). In this video,

✔ We break down the process of creating a course using lecture notes available in the public domain. We cover topics such as:

✔ Why create a course? What kind of content should you put in the course? How do you price the course?

✔ Who is your audience? Why does your course matter? How much time will you commit to making your course great? How much money will you make?

Let’s dive in!

1. Plan Your Course Before You Even Begin

Before you even begin planning a course, you must ask yourself why you’re doing it. This is one of the most common mistakes people make when trying to create their first course.

In fact, if you go through all 5 steps below without answering this question, you won’t know how to answer it later on during the course creation process.

2. Outline Your Content Strategy

Your outline isn’t supposed to be exhaustive. It’s only meant to show the important parts of your course. From here, you can use a variety of tools to flesh out your plan.

For example, consider including outlines of chapters, subtopics, etc., into the outline itself. Then, use Google Docs or a spreadsheet to keep track of them as you write.

3. Research Your Audience

Who are the people likely to sign up for your course? Is there anything unique or interesting about your target audience members that you could include in your course?

Where is your target audience located? Consider researching demographic statistics so you know where to focus your efforts.

4. Decide What Kind Of Course To Make

A good way to organize your course before you start writing is by deciding what kind, of course, you want to create.

Do you want to teach basic skills or more advanced ones? Or do you want to impart valuable information?

5. Figure Out The Best Channels and Mediums

Once you know what type, of course, you’re going to make, you’ll need to decide what channels you’re going to use to reach your audience.

Do you use email lists to share your course with people, or Facebook groups, Twitter, Instagram, Pinterest, LinkedIn, etc?

Remember to think about how you’re going to promote your course—do you have enough time to devote to promoting your course?

6. Create A Strong Call-To-Action And Promote Your Course

Once you’ve decided on the mediums that you’re going utilize to reach your audience, you’ll also need to figure out the call to action at the end of each section.

What do you expect users to do after they finish reading an article, watching a video, completing a quiz, etc.

Ask yourself this question when you’re thinking about your call to action because you don’t want to get distracted from actually teaching your audience something.

7. Get Feedback On Your Work

It might seem like it’s not worth getting feedback early on in the course development process – but trust me, it really helps.

When you’ve created a draft or two of your course outline, then the last step would be to seek feedback on the course so far.

If possible, get feedback from other instructors who specialize in courses similar to yours to see what could work well, or what could improve your course.

Don’t worry if it takes some time and effort to gather feedback; once you find someone whose opinion you respect,

Because of these seven reasons, you can earn a good amount of money by starting from the RCM business plan chart.

How To Establish an RCM Business Operation

RCM is an acronym for the Risk management process. Risk management is a process that can be applied to any business in order to ensure its viability and profitability.

It consists of assessing and controlling risks, as well as providing avenues for risk avoidance, transfer, and reduction.

An RCM business plan is defined as a company Business that provides services or products related to a particular field. In simpler terms, imagine having a food truck that offers breakfast tacos, lunch boxes, and dinner specials, based on your specific location.

This concept allows customers to customize their meals while getting the most value for their buck. It also opens up new opportunities for entrepreneurs since they offer personalized services Business that appeal to different customer demographics.

There are many ways to launch a successful RCM business plan. Some ways to develop a successful RCM business plan include:

1. Know Your Market

Start by understanding your market. Where does your target audience come from? You should conduct thorough research on where they live, work, play, hang out, etc.

If you’re in Canada, finding out more about your Canadian market will give you a better idea of who your ideal clients/customers are.

Remember, there is plenty of room for growth! By identifying potential markets, you’ll be able to focus on what appeals to them best.

For example, if you’re looking for a way to launch an online travel agency, knowing that millennials prefer eCommerce stores is great information.

2. Think About What You Want To Offer

After we identified our geographic area, consider asking ourselves questions such as: “How am I going to serve my market?

How am I going to differentiate myself from competitors? Do I have the right skillset? Am I willing/able to learn everything?”

These questions help us figure out what type of business we want to do digital operations. If you’re unsure what kind of business you want, visit sites like The Entrepreneur Institute to help you brainstorm ideas.

3. Determine Potential Revenue Streams

After you know what exactly suits you and the people you aim to service, it’s important to determine how you plan on generating revenue cycle management services.

What do you expect to monetize through your business? Is it something simple, such as offering discounts or freebies, or more involved, like consulting?

Think about how much money you need per hour before deciding whether to go ahead with your venture. This calculation will allow you to make a decision regarding how much revenue cycle management services you think your business can generate.

How to Acquire Customers for Your RCM Business Plan

If you’re starting a new RCM business plan, let’s assume that you want to attract new customers. If you’re a service-based company Business,

‣ The first step is to create an excellent initial customer experience – one that will make the customer feel confident that they can depend on your business.

‣ One of the best ways to do this is to ask yourself “what would I like if I were a customer?” and then provide it.

‣ This includes everything from answering questions in a timely manner to providing excellent customer service, and much more.

‣ Once you’ve done all of this, send your client a thank you note. This can really set you apart from other businesses because it shows that you care about your customers’ feelings.

‣ It’s also important that you get positive feedback from your clients so that you don’t lose any credibility or trust. Make sure that you respond as quickly as possible when asked a question. For example, if they write in to inquire about their order, reply within 24 hours.

‣ You should always strive to keep the lines of communication open since most clients will not hesitate to leave negative reviews on Google if problems arise.

‣ It’s important to remember that not every client will become a lifelong customer but at least a loyal one.

Marketing Tips for Successful RCM Business

1. What type of RCM Business are You Looking To Operate?

If you already have existing Rcm business operations (one that doesn’t currently offer services through a referral network) it may be smart to consider joining a partnership.

If your primary focus is working with businesses that are looking to hire employees then RCM could be perfect for you.

However, if you prefer to work with businesses that are looking for training opportunities, then running a training program might be a better option for you.

2. Decide Between Starting a New Business or Becoming an RCM Partner.

Some partnerships require an entrepreneur to start a business from scratch while others require that partners invest capital into a pre-existing entity.

In the case of RCM Partnerships, you’ll have access to a larger pool of potential candidates who are looking for employment.

In return, they’ll receive ongoing commissions from referrals even though they’re not actively creating leads for you.

As long as someone refers them, you’ll receive a commission on those hires. That’s why it’s important to maintain a good reputation.

RCM Partnerships can seem scary at first because there’s no guarantee that you’ll earn income unless someone completes a project or job opportunity for you.

Don’t worry! There are many ways to earn residual income without having to put up your own cash up front. Here’s a list of some of the top ones:

Referral programs in RCM Partnerships refer new businesses to other businesses using a variety of methods including direct mailers, emails, cold calling, phone calls, etc.

The average partner earns around 2.5% of the sale made by each referred employee. Some people refer clients daily, weekly, or monthly depending on what works best for you.

You’ll need to decide whether you want to Rcm business operations a lead generation business or a sales lead business.

In either case, you’ll need to develop a system to follow up with your prospects and help them find the kind of job they desire.

3. Affiliate Marketing

Affiliates promote products via websites, blogs, social media marketing, email campaigns, etc. They often take a cut of whatever the advertiser receives after paying the affiliate.

4. Home Based Sales

Home-based sales involve selling directly to consumers. This works great for some types of jobs like insurance sales, dental repair, lawn care, home improvement, etc.

Many people make enough money doing this to support themselves completely off the work they do online. If you’d like more information, check out my article on how to build a successful Online Store.

5. Training Programs

Training programs can range from simple courses to highly specialized skills. They allow organizations to train new hires at low costs and create a reliable way to recruit staff members.

How To Become an RCM Business Operation Partner?

• There’s No Guarantee Of Income In RCM
• Is It Possible For An Employee To Earn A Lot From Their Job?
• If You Have Any Other Questions Please Ask Me At Comments Below

Disclaimer: The Information On This Site Is Not Legal Advice And Should Not Be Used As Such. Use Of The Information Or Search Results On This Website/Blog Does Not Create Attorney-Client Relationship Or Consultation. Get Personalized Legal Help Today By Appointing One Of Our Experienced Attorneys To Handle Your Case.

Rcm Business Plan

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✔ Privacy Policy Copyright ©2020 All Rights Reserved. Disclaimer

✔ This page was last modified on 30th April 2020. The Content published on this page represents the opinion of the Author.

RCM Business APP

Rcm business official app We welcome brand-name companies as well as small independent contractors into the RCM community.

We’ve created a partnership program that allows individuals who provide services such as website design, SEO, local search engine optimization, virtual assistant, content creation, web development, video production, graphic design, copywriting, SEO writing, proofreading, editing, customer service, transcription…etc. to earn income and become a member of the RCM Network.

How is RCM Business Commissions Structured?

You may ask why would I join a network marketing company when I can just start working as an employee for anyone? Here is an answer for that:

“You’re not going to get rich overnight by being an employee”. However, you can easily earn extra cash through other means than having to wait for someone else to give directions to the right place to go. Some businesses will pay their employees bonuses if they hit certain targets.”

That is what we call ‘Bonuses’ that are not necessarily part of your salary or an hourly wage. Also, there are several reasons why employers will offer benefits such as health coverage, retirement plans, paid vacations, educational assistance, free lunches, etc.

Why Rcm Business Closed

The main reason for the closure of Rcm Business is the suspicion towards Rcm Business. We told all the direct sellers in the meeting that there should not be any company of RCM any anytime. In the talk of 2010, all the companies of that time have been published in the name of fraud.

Where is this thing at the moment? When he looked, he saw when it was the controlling company. And the orders for the running of the government were also going on in this order.

RCM Business is the only operating company in India that was open after closure. For some time all distributors were removed and the product was stopped in the market.

Problem Solving Tools Training Programs by RCM Business Plan

To take advantage of these services please fill out the form below.

If you do not meet one or more requirements listed above or simply prefer to work with another representative or distributor then feel free to contact the manager of your nearest branch.

‣ First Name ‣ Last Name ‣ Email ‣ Phone No. Country ‣ State ‣

Disclaimer: The information contained herein does not constitute legal advice but serves as general guidelines on how to build any type of home-based business.

While the authors have made reasonable efforts to ensure the accuracy of the information presented herein, it cannot be guaranteed nor implied that the information provided herein would apply to the specific circumstances referenced therein.

In addition, RCM® does not endorse or recommend any particular product or service available from the third parties mentioned.

Rcm Achievments

Talking about network marketing in India today, the maximum company comes from outside. They usually run their businesses here for a limited period of time before returning home.

But today RCM has become India’s No.1 network marketing company. Those who are staying in India are serving for India only. But along with this, RCM has grown so much that now they are going to start their business in foreign countries too.

There is not much time left before this news starts coming. It will be known that Rcm business products are spreading rapidly in other countries also.

FAQ [frequiently Asked Question]

It is a time of exciting growth for the Indian Direct Selling market. The direct selling industry has seen unprecedented success in 2016, with a total turnover of Rs 10,000 crore and over 3 million distributors in the country. These are some things you can do to grow your business: RCM is a business that helps physicians with their medical billing and coding. This industry has been growing steadily in recent years, with an estimated annual growth rate of 12%. Many factors are contributing to this growth, including more stringent requirements for electronic medical records (EMRs) and Meaningful Use Stage 2 guidelines.

What Is the Full form of Rcm business?

The full form of RCM business stands for Right Concept Marketing. The company specializes in direct selling. This allows the company to sell products directly to customers.

Why Rcm business closed

The main reason for the closure of Rcm Business is the suspicion towards Rcm Business. We told all the direct sellers in the meeting that there should not be any company of RCM any anytime. In the talk of 2010, all the companies of that time have been published in the name of fraud. Where is this thing at the moment? When he looked, he saw when it was the controlling company. And the orders for the running of the government were also going on in this order. RCM Business is the only operating company in India that was open after closure. For some time all distributors were removed and the product was stopped in the market.

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Summary & Conclusion Start RCM Business Operation

How Can You Start Your own Online Home Based Business from Anywhere?

With this option, there’s no need to visit any office located anywhere. And since online business is very simple to set up, starting an online business has never been easier.

This program also includes a special bonus called ‘RCM business products List Starter Kit’. It contains over $500 worth of products including the most popular software tools used by thousands of people around the world.

All you need is a computer connected to the internet. Most computers already come equipped with email programs, and word processing features.

The good thing about running an online business is that you can conduct it from anywhere! So, you don’t need to worry about traveling long distances to attend meetings and seminars, or more…

‣  I hope friends, through this article, I have given you information about  How To Build a Successful RCM Business RCM Business Plan,  You must have got the information. So share your suggestions with us.

Like this information Or have Something to share!

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Five pivotal rcm trends reshaping healthcare beyond 2024.

• BY: Ashu Gupta
• Posted On: January 5, 2024

Revenue Cycle Management (RCM) is undoubtedly the lifeblood of the healthcare industry, ensuring financial stability and operational efficiency. As 2024 unfolds, the RCM’s landscape is set to undergo significant transformations driven by technological advancements, policy changes, and shifting patient dynamics. These changes not only impact how healthcare providers manage their finances but also how they deliver patient care. In this article, we’ll explore five pivotal trends identified by Becker’s Hospital Review , each shaping the future of healthcare RCM. From the continued challenges in labor to the impressive strides in artificial intelligence, the evolution of prior authorization requirements, the march towards innovative payment models, and the increasing importance of patient payments – these trends offer a roadmap for healthcare providers navigating the complexities of tomorrow’s healthcare sector. These trends provide insight into the strategies and technologies that will drive the success of RCM in the years to come, ensuring that healthcare providers can continue to deliver exceptional care while maintaining financial health.

1. Continued Labor Challenges: Adapting to a Transforming Workforce

The RCM space, like many sectors in healthcare, is not immune to the challenges posed by labor shortages. Over 60% of hybrid workers in RCM are at risk of leaving, causing staffing shortages in healthcare systems. This leads to more reliance on contracted labor , which is costly and can lead to burnout and high turnover rates. This cycle puts pressure on healthcare systems financially and operationally.

Healthcare organizations are increasingly turning to offshore medical billing companies or offshore medical coding companies to manage labor challenges and financial pressures. Cloud computing advancements and improved security measures have made global resources a more appealing option. Outsourcing enables organizations to focus on their strengths and allocate more resources to areas where they excel, increasing efficiency.

Alongside outsourcing, the investment in generative AI and automation is gaining momentum. Artificial intelligence and automation demonstrate their value across RCM and clinical care.

In 2024 and beyond, automated coding, denial management, and pre-authorization are expected to be these technologies’ primary application areas. However, the introduction of these technologies isn’t without its challenges. Concerns about job security among staff and apprehensions among patients, especially concerning data privacy and quality of care, are notable. Healthcare providers must communicate that these technologies are meant to augment staff roles, not replace them. Transparency about the benefits of these technologies in improving patient care and safeguarding data is crucial to overcoming resistance and building trust.

2. Advances in Artificial Intelligence: Revolutionizing RCM Processes

Integrating Artificial Intelligence (AI) in RCM is not just a futuristic concept but a current reality; 60% of healthcare providers are actively considering investing in generative AI. In the future, AI’s role in RCM is expected to expand, especially in processes such as claims coding and pre-certification. For example, AI can be used to identify and analyze denied claims. This can help healthcare providers develop strategies for appealing these denials by recognizing common patterns in the claims. Additionally, AI can automate the process of posting payments to patient accounts. This helps to reduce the workload on RCM staff and enhances the accuracy of payments.

Another area where AI is making strides is in patient engagement . The development of AI-driven chatbots and other tools is revolutionizing how patients interact with their billing processes. This improves the patient experience and reduces the number of patient inquiries, streamlining the entire billing process.

In addition to improving patient engagement, AI is instrumental in identifying and analyzing denied claims. This capability allows providers to develop targeted strategies for appealing denials by recognizing patterns in these claims. Likewise, AI is being utilized to automate posting payments to patient accounts, significantly reducing the workload on RCM staff and improving the accuracy of payments. As AI continues to evolve, its ability to handle complex RCM tasks is undoubtedly increasing, leading to more efficient and cost-effective revenue cycle processes.

3. Prior Authorization Requirements: Embracing Efficiency through Technology

The significance of technology in streamlining prior authorization requirements is becoming more apparent, with the cost of a fully electronic transaction being less than 20% of a manual one. In 2024, payers must comply with new Medicare Advantage marketing requirements, price transparency regulations, and prior authorization policies . The final rule includes policies to streamline prior authorization requirements to reduce care delays for Medicare Advantage beneficiaries. For example, prior authorization can only be used to confirm diagnoses or medical necessity, and plans must provide a 90-day period where prior authorization is not required when a beneficiary switches to a new plan.

One of the significant changes being implemented is the final rule that aims to simplify the prior authorization process. Under this rule, prior authorization would mainly be required to verify medical necessity or confirm diagnoses. Furthermore, a new policy has been introduced, which mandates that insurance plans must provide a grace period of 90 days where no prior authorization is needed when a patient switches to a new plan. This step will help in ensuring smoother transitions for patients.

The Transparency in Coverage rule, also set to be fully implemented in 2024, requires health plans to provide transparent information about the costs patients are responsible for. This level of transparency is crucial as it helps patients make informed healthcare decisions and assists providers in streamlining their billing processes.

The shift towards electronic and transparent prior authorization processes is a significant stride towards making healthcare more accessible and efficient. These regulations are set to transform how payers, providers, and patients navigate the complexities of healthcare delivery and financing.

4. The March to New Payment Models: Embracing Value-Based Care

As Value-Based Care continues to expand its impact, RCM is establishing closer working relationships with clinical departments. This shift emphasizes the need for RCM to be more integrated with patient care, ensuring that financial processes align with clinical outcomes. Integrating AI into healthcare systems is critical in enhancing various aspects of RCM and streamlining medical billing workflows, patient registration, and claim submissions. For instance, real-time digital eligibility verification helps providers ensure the accuracy of patient information at check-in, enhancing revenue integrity.

The healthcare industry is moving slowly but surely towards value-based care payment models. According to a recent report by McKinsey , the number of patients treated under these models is expected to almost double in the next five years, with an annual growth rate of approximately 15%. This shift is part of a larger healthcare trend emphasizing value and positive patient outcomes.

The shift towards patients covering a greater share of their medical expenses has spurred a growing need for more transparent billing experiences. Financial engagement intelligence solutions are addressing this demand by offering diverse patient payment options, including implementing mobile pay. These solutions simplify the payment process and provide payment plans and flexible options, easing the financial burden on patients and simultaneously helping providers boost their revenue. By improving the patient financial experience, providers can positively impact their revenue and patient satisfaction. This focus on patient-centric financial experiences is becoming an increasingly vital component of contemporary RCM practices.

5. Increasing Value and Complexity with Patient Payments

The significance of patient payments in RCM has been escalating, particularly as a notable portion of U.S. workers, around 31% in 2020, are enrolled in High Deductible Health Plans (HDHPs). This trend is causing a shift in the RCM landscape, requiring healthcare providers to navigate more complex patient payment models. There is a rising demand for digital billing solutions and convenient payment options, reflecting the broader consumer inclination towards digital and accessible solutions seen in other industries.

Healthcare providers are adopting online payment tools to provide easy accessibility and more control to patients. Patient-friendly billing solutions that include clear cost communication, flexible payment options, and a streamlined digital experience are becoming increasingly vital. Healthcare providers can improve their financial stability and boost patient satisfaction and loyalty by focusing on these areas. This approach aligns with patients’ evolving needs and expectations in modern healthcare.

Discover the Future of RCM with GeBBS Healthcare Solutions

The five RCM trends shaping healthcare beyond 2024 represent a mix of challenges and opportunities. Healthcare providers must navigate a rapidly changing landscape, adapting to labor shortages, technological advancements, and complex payment processes. Staying ahead of these trends means embracing innovation, fostering adaptability, and continuously striving to balance operational efficiency with high-quality patient care.

As healthcare providers face the challenges and opportunities presented by the evolving RCM trends, choosing the right partner to navigate this complex landscape cannot be overstated. This is where GeBBS Healthcare Solutions, one of the largest healthcare RCM companies, steps in as an essential ally.

GeBBS Healthcare Solutions offers cutting-edge technology-enabled RCM and Risk Adjustment solutions . Their AI-integrated data analytics platform helps healthcare organizations make smarter, data-driven decisions and navigate the industry’s complexities. GeBBS’ iCode technology optimizes medical coding and auditing workflows, enhancing the overall efficiency of RCM processes.

Visit GeBBS Healthcare Solutions today to discover how they can help you improve financial outcomes while positively impacting your clients.

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The Road to RCM

November 2022, by bryan elmore.

Auburn University successfully implemented a responsibility centered management budgeting model, though not without a few bumps along the way. 

Today’s higher education institution business models are under increasing pressure in response to multiple factors, including major demographic shifts and enrollment declines, reduced state support, and increased efforts to provide more institutional aid to more students. As institutions seek ways to maintain long-term financial viability, more are exploring alternate budgeting models.

Auburn University, Auburn, Ala., began an exploratory process for a new resource allocation model in late 2011. The initial conversation was little more than a casual chat with a consulting firm to discuss options. In late 2012, the potential for adopting a new model gained momentum when Auburn’s provost at the time reached out to the CFO to collaborate on a project that would help revitalize a stagnant allocation process. After a lengthy implementation phase, which included due diligence by several constituency groups on campus, Auburn adopted its RCM model for full use in developing its FY17 budget.

This article details our process, including questions and concerns that emerged from various stakeholder groups, adjustments we made, and lessons learned that may prove useful for other institutions considering an RCM model.

When I began working at Auburn as a senior accountant in November 2005, it employed an incremental model for the largest portion of its overall budget. The most tenured members of senior administration could not remember a time when Auburn did not operate under this method, which involved pooling our largest sources of revenue (state appropriations and tuition) along with a few other smaller revenue sources into our base (or general fund) budget. These pooled resources were allocated to provide expense limits for units within the base budget. These funds represented about 65 percent of our overall budget, and it was revised annually based on expected changes in revenue and mandatory or strategic expense increases.

Despite the impression that Auburn operated strictly with an incremental budget, some components of our business practices did reflect key principles of an RCM-style model. For instance, we have always allowed funds to be carried over and allowed units that generated funds at the local level to retain those funds within the units. Because of these and some other practices, I assumed our transition to RCM might be less of a culture change.

For numerous reasons, at the outset the provost and deans were in favor of a new methodology for allocation. One reason was that we had become increasingly dependent on tuition in the aftermath of the Great Recession. In 2008, tuitionand fees made up approximately 44 percent of our unrestricted budget. By 2012, that had increased to 63 percent. In addition to changes in the mix of revenues, marketplace competition for nonresident students had also increased dramatically. Our enrollment model is built on a certain percentage of nonresident students and recruiting and retaining those students had become more difficult than ever before.

Commencement of Auburn’s RCM project—what we call our Strategic Budgeting Initiative—launched in early 2013 with the establishment of a steering committee to devise the guiding principles under which the model would operate. Our provost and CFO led the committee, with representatives from both the academic and administrative organizational structures. Because academic leadership wanted to know more about how the budgeting process would work, one of our initial guiding principles was to ensure that the model would be transparent. The second crucial principle, vetted through the steering committee, was to make sure we would build a model that was simple.

Plan Your Model Rollout

Implementation of the new model was broken into four main phases.

Phase 1: Assess the flow of funds. The first phase was to complete a funds flow assessment. To have any concept of where we wanted to go, we needed to fully understand how the funds were coming into the university and how those resources were being allocated to the different units on campus.

Given the magnitude that tuition and fees played in our financial model, it wasn’t surprising that the colleges were producing well over half of our revenue. What was a bit shocking was the level of subsidization needed in some of those disciplines that had a higher cost of instruction. In the initial funds flow assessment, the vast majority of our 12 degree-granting colleges or schools required some level of subsidy before factoring in university overhead costs.

Phase 2: Build the model. The second phase of implementation was the actual model build. The project consultant worked closely with the steering committee to identify which behaviors or functions we wanted to incentivize, levels of allocation at which those incentives might be created, grouping administrative/overhead units, and metrics by which the overhead units would be allocated to the revenue-generating units.

This phase was time-consuming because it required completing several iterations that would be acceptable to the steering committee and meet approval from the rest of our campus. It has always been central to Auburn’s brand to provide a positive undergraduate experience, so most of our model allocations were built around incentivizing instruction for undergraduate students by setting the allocation percentages for our undergraduate tuition pool at 70 percent to the college of instruction and 30 percent to the college of major/record.

Under the model, 70 percent of our state appropriations were allocated based on in-state student tuition, further incentivizing the instruction mission. The remainder of the state appropriations was allocated proportionate to the sponsored activity generated. So, while there were incentives for research productivity, they were overshadowed by the incentive to produce credit hours.

Our decision to group administrative units may be contrary to what one might expect. Instead of trying to group solely by the organizational chart of the institution, we tried to look at the function of the subunits within each major unit and determine the most appropriate home. We ultimately settled on six pools: academic and student services, administration, alumni affairs and development, facilities, sponsored research, and universitywide support. To illustrate that we were trying to place the subunits based on function and not by organizational chart, business and finance has units that fall under four of the six pools.

Finding the proper metric by which the administrative units would be allocated was also a challenge. We were up-front with everyone that there was no perfect variable we could use to allocate the costs of the central units, but we aimed to use the data point that made the most sense. For example, the variable chosen to allocate the academic and student services pool was "student credit hours instructed."

One of the more interesting discussions might have been the variable that made the most logical sense: "square footage to allocate the facilities pool." The point of contention was that our model did not account for quality or type of space (old vs. new, or lab vs. office vs. classroom). We ultimately convinced the detractors that the model allocation methodology was not intended to assess the quality of a space, rather the purpose was to serve as a mechanism by which to allocate the budget for facilities.

Phase 3: Build consensus. Our third phase of implementation was consensus-building. This is the area where we struggled most to gain traction. Most of our deans agreed that we needed to do something different since the allocation of resources was not reacting to current trends in enrollment and provided them no incentive to be strategic in their financial planning. Some were also fearful of how a deficit might impact their peers’ perceptions of them.

The greater campus community—specifically faculty—felt its opinions were not included for consideration and wanted a chance to vet the decisions made by the steering committee. The university senate asked for the opportunity to put together an ad hoc committee to study the model and offer input on changes.

After nine months, the university senate’s ad hoc committee delivered its recommendations. Chief among them was to advocate for a weighting structure for credit hours to quantify the cost of instruction. This was done in an effort to improve the large deficits of some of our higher cost of instruction colleges that had been modeled during the process. In the end, that recommendation was closely voted down by the senate.

The senate ultimately accepted the other recommendations of the ad hoc committee: (1) to provide for governance structures at the college level to determine no one department was negatively impacted by a dean’s decision; and (2) to ensure that the colleges and schools would have some security blanket from year-to-year with the amount of subvention provided. The administration agreed to review those on a case-by-case basis.

Not long after receiving the senate’s recommendations, we made the decision to move forward. While the review process of the university senate certainly slowed the momentum of the project, it was important to give this group an avenue to participate and provide the feedback it felt would make the model more acceptable to faculty. This process also demonstrated that shared governance remains an honored practice at Auburn and allowed each constituency to feel it can have a say in decisions that affect the entire campus.

Phase 4: Deploy the model. The fourth and final phase of implementation was deployment of the model. This phase took approximately 18 months. Part of this time was spent by our budget and planning services on learning the Excel workbook used to administer the model’s allocation methodology, along with renovation of our homegrown budget development tool. A significant amount of time was spent training the rest of campus on how the model worked and how to manage it with this tool.

Test Before Going Live

We actually spent FY16 building out reporting in what was considered our "shadow year"—a concept recommended by our consultant as a normal practice for such allocation redesigns. While this shadow year allowed us to test the numbers against the methodology one more time, it was more about trying to make sure that our office could manage the operational aspects.

For instance, we had to rebuild our homegrown budget development tool to accommodate the methodology. We also had to build quarterly reporting around the data variables used for allocation of the revenue and administrative costs.

During our shadow year, we were able to accomplish all these tasks, which ensured that we were capable of moving forward with the RCM model as adopted by the steering committee and the rest of the campus. No additional changes were made to the model because the numbers still showed that the methods were sound. During summer 2016, we built our first budget with the model in place for FY17.

The final construct of our model was to break allocations into four major categories: revenues (both direct and allocated); expenses (direct); central unit allocation (overhead allocated to revenue-generating units); and mission enhancement funds (taxes on academic revenues to cover subvention and strategic investments). We have now been live with our model for three full years and are currently operating in our fourth year.

Anticipate Potholes

As expected, there have been some bumps along the way.

Governance issues. As one example, organization of the governance committees was lacking during the first two years of being live with the model. Because all our university committees are a cross section of the campus, with the different constituency groups having representation and with annual rotations on and off, the education of the committees on the specifics of the allocation methodology has been the biggest challenge.

Each year, most of our initial meetings have been spent walking through what role the committee plays in the process and diving into model mechanics. In addition, the overall direction of the committees in the initial stages was lacking due to leadership transitions. Consequently, past practices of top-down approaches to budget decisions endured and the committees, feeling they weren’t adding value to the process, simply rubber-stamped what was presented.

The most recent committee process provided reason for optimism, specifically in the committee with oversight of the administrative unit budgets. With clear budget parameters and guidelines, the committee had a stake in the conversation and began asking difficult questions about proposed budgets and making recommendations about reductions. In some cases, it actually recommended units increase their proposals because it felt the budget was inadequate to support the university’s mission.

Unique operational areas. Another challenge that exists is how to operate with the two divisions that help support our land-grant mission. With so much interconnectedness through appointments at the Alabama Agricultural Experiment Station (AAES) and Alabama Cooperative Extension System (ACES), there are difficulties ensuring that funding is appropriately handled between all appointments.

Currently, we are still struggling to keep those stated assignments intact. Because the two units are viewed independently by our state and receive separate appropriations with very little other unrestricted revenue, inevitably more of the burden is shifted to Auburn’s main campus budget. This has a global impact on the other colleges and schools that do not have affiliations with AAES and ACES.

While maintaining autonomy for AAES and ACES, we have been trying to take a more holistic approach when we review the operations of our colleges and schools that do have affiliations with these units. We did not contemplate the impact these operations would have, and RCM implementation suffered in the first two years by not having a plan in place.

While this may be a problem specific to land-grant institutions, other schools may have similar considerations to make about other operational areas of the institution (e.g., auxiliaries, athletics, or other separately budgeted divisions) and how they influence decisions around allocating overhead.

Tweak as You Go

We are now coming up on our five-year review period, when we will unlock the model and begin testing different assumptions about allocation variables or percentages. When we started implementing our RCM model, we said that while we had to give it a chance to work, we would need to review it periodically to make sure we were incentivizing the right behaviors or to make changes in support of different strategic initiatives. Because we placed a heavy incentive on teaching credit hours, we are contemplating lowering our allocation of tuition to the college of instruction. We’re also considering revising the participation rate assessed on the revenues of the academic units. The initial rate was appropriate at the time, but we need to revisit it.

In that same vein, we’re also looking at which revenues should be assessed. Currently all unrestricted revenues (with the exception of finance and administration recovery) receive the charge. This includes all locally generated revenues such as fees collected for online tuition, sales of products, or clinical operations. If we were to shift course and assess those fees on allocated revenues only, it should result in an increased incentive for the colleges and schools to be more entrepreneurial. With an effort to improve our research profile, I would expect to see a greater emphasis placed on the research mission. We could accomplish this by increasing the amount of state appropriations allocated proportionate to sponsored activity.

RCM Readiness

Unfortunately, my hunch about a smooth transition to RCM was wrong. Even though there was consensus among academic leaders that a change was needed, there was also anxiety. Despite a desire by the majority of key stakeholders to attempt a more data-driven approach to resource allocation, it proved a challenge to change the mindset of those who saw the allocation process as an annual exercise instead of as a way to plan for the future.

In addition, because RCM requires a level of accountability that was largely nonexistent in our previous model, some are still trying to navigate those waters. So, one thing any institution must do before it entertains a change of this magnitude is to assess the readiness of the campus for the cultural change that will come and factor that into the implementation process.

Skill sets. You also must evaluate the skill sets of those who are in business management roles and work to complement their strengths with the expertise of other leaders. For the institution to be successful, you have to ensure that no one unit is lacking the talent to manage the financial portfolio of its area, and you have to be willing to coach them through the challenges they may face. We have made strides to hire capable personnel in the necessary areas, worked to provide them with the tools needed to be successful, and are continually evaluating ways to improve.

Technology tools. We also considered our readiness to implement a new budget system at the same time we were implementing the RCM model. In the end, we did not feel we could incorporate the additional change to the process without creating turmoil with our campus business personnel, so we postponed its consideration until our more recent implementation of Anaplan, a web-based enterprise platform for business planning.

As you consider undertaking a system conversion, think about what you ultimately want out of a software tool as you design the interface for your campus community (see sidebar, "Don’t Forget the Tech Supports"). Provide others the opportunity to participate in the RFP process and user acceptance testing and be sure to deliver training materials that can make things easier for them. Identify a project leader who has a skill set with a mix between technical and functional. I was fortunate to have an individual who met that criteria as well as an entire staff in the budget and planning services office that had varying skills to help make the implementation a success.

Collaboration. Finally, the most important factor for success is to create a collaborative environment with all stakeholders on campus. From the beginning, we had a broad-based group of campus leaders involved in the RCM implementation process, including some faculty on the steering committee.

However, as we progressed through the project it became evident that we should have opened the lines of communication with a broader group of the faculty constituency. The chief complaint from faculty leadership was a lack of understanding of the model concepts. Engagement with the group much earlier in the process might have allowed us to implement the model a year earlier. That said, the additional time was crucial for us to provide extra opportunities for our campus to develop a better understanding of the math behind the model.

Overall, Auburn’s RCM implementation was a success, despite a few bumps along the way. Our primary goal—to create transparency and accountability with our resource allocation methodology—was accomplished. Unit leaders have an understanding of how the revenues and administrative overhead are being allocated. As a result, deans are more actively engaged in recruiting students, decisions about unit-awarded tuition discounts, and strategic decisions around academic program creation, as well as monitoring expense trends.

The university community is also becoming more engaged in a connected financial planning process that integrates multiple functional areas in order to evaluate our ability to successfully fund long-term strategic objectives.

BRYAN ELMORE is assistant vice president, budgets and business operations, Auburn University, Auburn, Ala.

We also had to build quarterly reporting around the data variables used for allocation of the revenue and administrative costs.

The most important factor for success is to create a collaborative environment with all stakeholders on campus.

Don’t Forget the Tech Supports

From my perspective, the biggest improvement I had hoped to gain from a shift in Auburn University’s resource allocation methodology was the opportunity to improve our planning capabilities at both the local and university levels. To do that, we knew we needed to modernize some of our technologies for budget development and long-term financial planning.

Our previous development platform was a homegrown tool that was little more than a web-based Excel spreadsheet with the ability to input amounts for line-item budgets only. It did provide integrations for labor data from our ERP system, but the overall capabilities were limited. We ultimately decided to move to the web-based platform Anaplan to satisfy our budget development, reporting, and long-term planning needs.

Increase efficiency and usability. First, we were able to take the RCM model that was housed with an Excel workbook and turn it into a much more efficient tool that would also lessen the margin of error. We have built some of our management reports inside of the tool, with more on the way. We have given senior executives the ability to view real-time dashboards with performance metrics that have been calculated with data inside of the platform.

Allow for unit projections. In addition, Anaplan gives us the ability to let our academic units prepare "what-if" scenarios using the calculated widget rates under the RCM model. For instance, a college can plug in the number of credit hours it expects to teach in a given year and the number of credit hours of its major students. They would also need to include other crucial data (e.g., square footage, students, employee full-time equivalency), as well as some of their direct revenues and expenses and generate a profit and loss statement for that year or for many years out. They can also do this with different credit hour scenarios to compare and contrast them for one year or multiple years. It also gives other units the ability to do their own long-term planning with these individual plans consolidated into one overall budget plan for the future.

Encourage cross-functional planning. In addition to the unit operational planning, Anaplan allows us to set up multiple models for our major functional units, which could facilitate a fully integrated strategic planning process. In this process, specific data from each model would be incorporated into the other models, informing our ability to make decisions about resource allocation or availability.

For example, if we had an enrollment growth plan, the outputs of the enrollment model could be imported into an auxiliary services model that could provide information on whether new housing or dining venues are needed. At the same time, the enrollment model outputs could be sent to a human resources model that could show a need to hire additional personnel to accommodate the proposed growth. The ultimate goal is to allow for all models to feed an overall long-term financial plan that will provide us valuable insight for the future.

Ultimately, we hope to take this data, coupled with our other financial modeling tools (such as the former Whitebirch, now Synario, financial modeling platform) to give us information about long-term bond rating projections, cash flow projections, and other key ratios.

In the end, this would give our board of trustees the complete picture as it is making decisions about capital projects and various other resource investments because of a completely transformed way of thinking.

More on RCM

Interested in reading more about RCM? Check out for a research perspective on its efficacy.

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December 8, 2023

16 min read

RCM and Claims

RCM: The ultimate guide to Healthcare Revenue Cycle Management

Learn about RCM, including what it is, what it involves, and how to improve it for practice success.

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At a glance.

• Effective healthcare revenue cycle management (RCM) for independent practices hinges on integrating skilled staff, clear policies, and advanced technology to manage the complex process of insurance and patient billing.
• Major RCM challenges include reduced insurance reimbursements, increased patient financial responsibility, complex insurance policies, evolving payment models, and staffing shortages, all of which impact provider financial health and operational efficiency.
• To improve RCM and achieve financial sustainability, practices must focus on comprehensive strategies like leveraging analytics, improving patient payment processes, conducting regular audits, and ensuring compliance, while adapting to trends like value-based care and increased demand for price transparency.

Unlike many other industries, healthcare requires a multistep, retrospective payment process. Healthcare providers render a service and often don’t receive reimbursement for weeks — or even months. The process by which providers are paid, known as revenue cycle management (RCM) , only goes smoothly when those providers prioritize people, policies, and technology in the following ways: 

• Employ highly skilled medical billing and medical coding staff who understand complicated payer requirements.
• Draft clear and concise RCM policies and procedures.
• Leverage RCM technology and analytics to promote revenue integrity, improve charge capture, and increase patient engagement. 

It’s a tall order, and many healthcare organizations — including health systems and independent practices — struggle with one or more of the RCM strategies listed above. 

In this article, we’ll dive into this pressing question: What exactly is healthcare’s revenue cycle? We’ll provide revenue cycle management steps and outline the benefits of revenue cycle management. Finally, we’ll discuss how to improve revenue cycle management to help healthcare providers promote financial sustainability.

What does RCM stand for in healthcare?

Healthcare revenue cycle management (RCM) is an umbrella term for the multistep process healthcare providers use to identify, manage, and collect revenue. Healthcare revenue cycle management begins the moment a patient schedules an appointment and ends when the provider collects all the reimbursement to which they’re entitled. This includes any amount insurance companies and patients owe. 

“ Healthcare revenue cycle management begins the moment a patient schedules an appointment and ends when the provider collects all the reimbursement to which they’re entitled.  ”

Over time and with the rise of high-deductible health plans (HDHPs), patients are increasingly responsible for a larger portion of their healthcare bills. For example, 29% of covered workers are now enrolled in a HDHP. Some sources estimate this number is well above 30%. 

This means that if healthcare providers want to improve revenue cycle management, they must engage patients and improve patient payments. Patient engagement directly benefits revenue cycle management. In fact, it’s safe to say that there is no healthcare revenue cycle management without patient engagement.

Pro tip : To improve healthcare revenue cycle management, focus on patient engagement. As patients’ financial responsibility continues to increase, providers must engage insurance companies and patients equally.

What are some of the biggest healthcare revenue cycle management challenges?

For today’s healthcare providers, revenue cycle management challenges happen every day. Here are some of the most significant ones to emerge over the last few years:

Decreased reimbursement from insurance companies

In its calendar year 2024 Physician Fee Schedule Final Rule, Medicare finalized a 3.4% payment cut . It’s not surprising that 38% of physicians say the financial state of their medical practice has worsened , with only 60% meeting their revenue goals . Across the board, healthcare providers haven’t been able to keep up with inflation. Medical practices need a plan to offset this decrease and improve revenue cycle management. Together, effective RCM processes and analytics promote financial sustainability.

Healthcare disruptors

Nontraditional, lower cost, and easier-to-access healthcare disruptors make it harder for independent providers to attract and retain patients and maintain a steady revenue stream. Practices need to engage patients proactively even before they schedule an appointment by focusing on search engine marketing , advertising, and social media . Standing out from competitors directly benefits revenue cycle management. 

Increased patient financial responsibility

More cost-sharing arrangements between patients and insurance companies make it harder for to collect patient payments. Practices must focus on transparent prices and leverage technology that makes it easy for patients to pay.

Further Reading

Insurance complexities.

The complexity of the insurance system makes it challenging to get paid correctly and on time. Medical codes and billing requirements change frequently. Across HealthCare.gov insurers with complete data, nearly 17% of in-network claims were denied in 2021. Insurer denial rates varied widely around this average, ranging from 2% to 49%. 

Shifting payment models

The shift from fee-for-service to value-based payments creates economic uncertainties that make it difficult to predict risk and forecast revenue. Medical practices need RCM analytics to make informed business decisions.

Staffing shortages

Difficulty recruiting and retaining revenue cycle management staff not only drives up costs, but also has consequences for compliance and cash flow. For example, nearly all respondents to a recent survey said healthcare staffing shortages continue to negatively impact revenue cycle management and patient engagement. 

These same staffing shortages also affect insurance company reimbursement, patient payments, and the patient experience. In 2022, front office staff experienced a 40% turnover rate , with clinical support and business operations support staff turnover rates close behind at 33%.

“ Nearly all respondents to a recent survey said healthcare staffing shortages continue to negatively impact revenue cycle management and patient engagement.   ”

Being short-staffed impacts healthcare revenue cycle management. In 2022, 56% of medical groups reported that their time in accounts receivable (A/R) increased, often due to staffing difficulties. In addition, short-staffed billing departments may need more resources to manage claim denials .

Why is healthcare revenue cycle management important?

Revenue cycle management — particularly medical billing and medical coding — is important because it helps providers get paid under fee-for-service and value-based payment models. 

Revenue cycle management imposes structure on an otherwise complicated process vulnerable to errors and omissions. It ensures healthcare providers have the right staff, practice management policies and procedures, and charge capture technology in place for efficient claims processing and revenue integrity. 

Without revenue cycle management, healthcare providers may leave money on the table or risk denials, recoupments, and fines. 

What are the benefits of healthcare revenue cycle management?

Some benefits of revenue cycle management include the following:

• Enhanced charge capture for revenue integrity
• Cleaner claims
• Improved medical coding and medical billing efficiency
• More reliable RCM analytics for strategic business decisions
• Positive insurance company relations
• A smooth patient financial experience that enhances patient retention
• Steady cash flow

Effective revenue cycle management ultimately helps medical practices focus on what’s most important: high-quality patient care. 

“ Effective revenue cycle management ultimately helps medical practices focus on what’s most important: high-quality patient care.  ”

Smooth revenue cycle management puts everyone’s minds at ease knowing that services rendered will be reimbursed correctly and on time. This is especially important for independent practices. Cash flow is critical for investing in new technology, marketing the business , paying salaries , covering overhead, and more.

What are the revenue cycle management steps?

While the specifics vary by practice size and specialty, the basic 10 RCM steps are the same: 

• Pro tip: Patient-completed digital intake forms reduce errors.
• Eligibility verification and prior authorization. Staff verify coverage and obtain any necessary prior authorizations from insurance companies.
• Patient visit and care delivery. Providers deliver care. 
• Pro tip: Develop tip sheets or electronic health record (EHR) templates with up-to-date medical codes.
• Coding. Medical coders and billers assign ICD-10-CM, CPT, and HCPCS codes based on clinical documentation .
• Pro tip: Select a clearinghouse that operates nationally, provides online access and real-time support, and explains error codes. 
• Payment posting and reconciliation. After insurance companies process a claim, they remit full or partial payment or issue a denial. When payment is rendered, practices reconcile that amount with the anticipated payment to identify and investigate potential underpayments .
• Pro tip: Up-front collections prevent back-end follow-up. Make it easy for patients to pay digitally, promote price transparency, and offer payment plans .
• Denial management. Staff investigate and potentially appeal any denials. 
• A/R follow-up. Staff follow up on unpaid balances from insurance companies and patients. 

Each of these revenue cycle management steps are critical. That’s because each builds on the step before to result in accurate and timely payment. Devote equal attention to each step for the biggest return on investment.

What individuals in the medical practice are involved in revenue cycle management? 

Everyone plays a role in healthcare revenue cycle management. However, the specific steps necessary to gather information, submit claims, and process all payments usually require direct input from:

• Medical billers
• Medical coders
• Patient financial advocates
• Receptionists

These individuals are considered the revenue cycle management team.

How does healthcare revenue cycle management help with the flow of patient information?

Effective revenue cycle management ensures that patient information flows smoothly to the insurance company for processing and payment. Without revenue cycle management, information would remain siloed within the practice management system.

Collecting information

Technology integration is critical. For example, the first step in RCM (i.e., collecting the patient’s demographic and insurance data) occurs via the patient portal , digital intake form, over the phone, or in person. 

This data resides in the practice management system; however, with integration, this information is also easily accessible in the EHR where it’s linked with clinical data. For example, medical codes a physician in the EHR automatically populate a claim in the practice management system. This automation is impossible without integration.

Translating information to medical codes

After the patient encounter, medical coders and billers read clinical documentation and assign accurate, complete, and specific ICD-10-CM, CPT, and HCPCS codes to represent what occurred and why. 

Practices may or may not have internal edits in their billing software to identify potential errors and help to ensure clean claims . For example, many internal edits check Medicare local or national coverage determinations, national correct coding initiative edits, medically unlikely edits, and top denial reasons (e.g., upcoding, unbundling, incorrect modifiers, or mismatched codes).

Submitting information to insurance companies

Next, the practice usually submits the electronic medical claim to a clearinghouse. The clearinghouse scrubs the claim and double-checks it for errors. Once it passes inspection, the clearinghouse securely transmits the claim to the insurance company.

Remember: when insurance companies process payment, they only receive the claim — not the entire medical record. (The exception is when they request the record as part of a prepayment process or a post-payment audit .) That’s why medical codes must reflect patient severity, acuity, and services rendered. Omitting codes means the practice could lose money. Adding extra codes could lead to overpayments and recoupments — or to denials. 

Once an insurance company receives a claim, it begins claim adjudication. The payer may apply its own edits before paying the claim in full (or part) or denying it entirely. 

Insurance companies render payment via electronic funds transfer (EFT) . This transaction may include electronic remittance advice (ERA) to convey additional information such as contract agreements, secondary health plans, patient benefit coverage, expected copays and coinsurance, capitation payments, or Internal Revenue Service withholding. 

Insurance companies may also use claim adjustment reason codes (CARC) and remittance advice remark codes (RARC) to explain payment adjustments.

Payment reconciliation happens next. Medical billers compare and verify reimbursements with billed charges. They also investigate any discrepancies. For example, they may need to resolve a medical coding error, contractual issue, or technical problem. This is also when practices usually bill patients for the balance of the invoice if they haven’t already collected it. 

When there’s a denial, healthcare revenue cycle management promotes root cause analysis and follow-up. This process of information generation, transmission, reconciliation, and ongoing analysis is what makes RCM so important. 

Without good RCM, information would not flow from the healthcare provider to the insurance company to enable payment.

How can a healthcare organization improve its revenue cycle?

The best ways to improve revenue cycle management will be different for every practice according to its unique challenges. For example, one practice might struggle with A/R and denial management . Another might struggle with cash flow, patient payments, charge capture, or staff retention. 

“ The best ways to improve revenue cycle management will be different for every practice according to its unique challenges.  ”

But there are universal strategies that can help improve healthcare revenue cycle management. These include the following:

• Leverage healthcare revenue cycle management dashboards and customized reports to monitor denials and prevent them proactively. 
• Pro tip : Here are 5 areas where RPA can help healthcare providers improve revenue cycle management: ERA processing, payment processing, clinical note creation, payment plans, and 835 uploads.
• Outsource healthcare revenue cycle management to improve charge capture, medical coding, medical billing, and revenue integrity.
• Perform frequent medical coding and medical billing audits. 
• Prioritize the patient financial experience (e.g., give patients more and easier ways to pay) to enhance patient collections.
• Educate staff about common denials and how to avoid them .
• Stay on top of relevant coding guidelines and medical coding changes. 
• Use billing edits to catch errors and omissions before claim submission and ensure smooth claims processing and payment. 
• Work all claim denials in a timely manner.

What are the most important healthcare revenue cycle management policies and procedures?

Some of the most important revenue cycle management policies and procedures include the following:

Medical coding, medical billing, and claim submission

Who will assign medical codes, and how? What is the process for charge capture? What workflows will everyone follow to ensure accurate and timely medical claim submission?

Pro tip : To keep the claims submission process running smoothly:

• Maintain dedicated staff to focus on and address claim edits
• Prioritize timely charge capture and enter charges daily
• Submit claims to the clearinghouse daily
• Work claim edits daily

Clinical documentation improvement query process

When questions about clinical documentation arise, who will resolve those questions and how?

Denial management

Who will monitor and manage denials? Will staff prioritize certain ones?

Internal coding guidelines

In addition to official coding guidelines, will staff use any additional guidelines based on feedback from insurance companies or the desire for internal data tracking?

Key performance indicator (KPI) reporting 

What KPIs will the medical practice track, and how often? How will it calculate those KPIs? What will it do with the information? 

Medical coding and medical billing productivity standards

What are the expectations for coders and billers, and what happens if they don’t meet those expectations? 

Patient payments and collections

What will the practice require of patients? For example, will it require up-front collections? If so, how much? What is the process for balance billing the patient or providing refunds when necessary?

Registration and financial screening

What workflows will staff follow to ensure data integrity? Can the practice leverage digital tools that enable patient self-service (e.g., digital intake forms or patient portals)? Will staff offer payment plans or other means of financial assistance when applicable? If so, what criteria will they use to determine whether patients qualify?

What is revenue integrity, and how does revenue cycle management enable it?

Revenue integrity refers to billing and collecting all revenue to which a healthcare organization is entitled. Note that revenue integrity is not synonymous with revenue maximization. That’s because the latter often implies billing and collecting as much as possible without regard for legal and contractual compliance.

The National Association of Healthcare Revenue Integrity (NAHRI) says the goal of revenue integrity is to prevent recurring issues that can cause revenue leakage and/or compliance risks. 

Revenue cycle management enables revenue integrity by introducing oversight and a system of checks and balances that mitigates risk and promotes compliance. The combination of skilled staff, policies and procedures, and robust technology pave the way for accurate reimbursement. 

Pro tip : For more information about compliance program infrastructure, program adaptations for small and large entities, and other resources, check out the recently updated Office of Inspector General’s General Program Compliance Guidance . 

How can healthcare providers achieve revenue integrity?

Here are 3 strategies to achieve revenue integrity in revenue cycle management:

• Audit frequently. Medical coding audits help identify potential revenue cycle errors or omissions. Audits also help inform educational opportunities and workflow improvements.
• Leverage the right technology, including healthcare revenue cycle management analytics. When deployed correctly, the right technology can augment staff’s abilities through built-in claim scrubbers, automated eligibility, denial management tools, and more.
• Promote a culture of compliance. Ensure everyone understands the importance of revenue cycle management and their role in supporting it.

What is the link between healthcare revenue cycle management and financial sustainability?

Revenue cycle management is necessary to ensure financial sustainability because it helps with the following:

Poor cash flow management is one reason why small businesses fail.

In healthcare, good cash flow requires submitting accurate medical claims in a timely manner. Timely, clean claims are the key to a timely revenue cycle that ensures healthcare providers have access to cash when they need it. 

Not surprisingly, 42% of business owners say they’re re-evaluating cash flow and spending due to inflation. 

Contracts with insurance companies

Effective revenue cycle management empowers healthcare providers with the data they need to negotiate favorable contracts. 

Mergers and acquisitions

Identifying and addressing revenue cycle gaps can position healthcare providers favorably in the event of a medical practice sale or merger. 

Pro tip : During healthcare organization mergers and acquisitions, keep these revenue cycle management tips in mind: 

• Monitor KPIs such as the denial rate, days in A/R, net collection rate, and clean claims rate.
• Conduct ongoing medical billing and medical coding audits before, during, and immediately after the transition.
• Consider fully outsourcing healthcare revenue cycle management or augmenting staff with an outsourced vendor.
• Focus on the patient experience. Let patients know what they can expect during the transition and how it benefits them. 
• Prioritize change management to prevent costly staff turnover. 
• Standardize medical coding and medical billing guidelines, policies, and workflows to ensure consistency and efficiency.

Patient engagement and retention

Financial sustainability occurs when patients pay their bills in full and on time. Effective revenue cycle management is a prerequisite for this. Why? 43% of adults say they have received a medical or dental bill they thought contained an error. 

“ 43% of adults say they have received a medical or dental bill they thought contained an error.   ”

About two-thirds of these adults say the error involved being billed for something that should have been covered by health insurance. Other errors were being billed for services never received or for bills that had already been paid. 

Revenue cycle management prevents medical billing errors that can otherwise erode patient trust and delay patient payments, making it impossible to achieve financial sustainability. 

What are some common revenue cycle management solutions?

There are many types of healthcare revenue cycle management solutions that can help health systems and medical practices thrive. Here are 5 categories of solutions and examples of technology that fit into each one:

• Billing and payments : Practice management software, insurance eligibility, patient statements, and patient payments
• Care delivery : EHRs and telehealth
• Data and insights : Medical practice growth analytics, medical practice revenue analytics, and data cloud
• Medical practice growth : Medical practice reputation management software
• Patient experience : Online scheduling, appointment reminders, patient intake, text messaging, and patient portals

How does billing software help with revenue cycle management?

Billing software benefits revenue cycle management because it relieves the administrative burden associated with eligibility and prior authorization. It also keeps the revenue cycle team up to date with payer policies and new medical codes, reduces turnaround time for patient payments, and more.

What is the best way to measure the effectiveness of healthcare revenue cycle management?

KPIs are the best way to measure revenue cycle management effectiveness . Data will reveal areas where healthcare providers are performing well and areas where they need to improve. Here are few of the most important KPIs: 

• Avoidable write-offs as a percentage of revenue
• Clean claims rate
• Days in accounts receivable
• Days in discharge not final billed 
• Medical coding and medical billing productivity
• Missed charges
• Overall medical coding accuracy
• Point of service cash collections
• Underpayment recoveries

What should healthcare providers keep in mind about revenue cycle management moving forward?

Like many aspects of healthcare, revenue cycle management is constantly evolving. However, there are several trends worth noting. These include:

• Continued focus on the patient experience. This includes the clinical experience as well as the financial one. Patients will increasingly want seamless and convenient scheduling, treatment, and payment options.
• Persistent revenue cycle management staffing shortages. Staffing shortages may continue to challenge healthcare providers. Partnering with outsourced vendors, leveraging automation, or finding other creative ways to address shortages (e.g., grow your own medical coders or share resources with other medical practices) will be paramount.
• Push for price transparency . As patients become more aware of the cost of their care, they may be more selective in choosing providers based on price. Medical practices must provide high-quality care at the lowest price to attract and retain patients.
• Shift toward value-based care. The link between reimbursement, quality of care, and patient outcomes will only become more apparent in the years ahead. Medical practices must promote strategic alignment between revenue cycle management, innovative payment models, and value-based care.

Revenue cycle management is an exciting and critical aspect of healthcare delivery. Medical practices prioritizing patient care's financial aspect will experience sustainability in the years ahead.

You Might Also Be Interested In

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Lisa Eramo, freelance healthcare writer

Lisa A. Eramo, BA, MA is a freelance writer specializing in health information management, medical coding, and regulatory topics. She began her healthcare career as a referral specialist for a well-known cancer center. Lisa went on to work for several years at a healthcare publishing company. She regularly contributes to healthcare publications, websites, and blogs, including the AHIMA Journal. Her focus areas are medical coding, and ICD-10 in particular, clinical documentation improvement, and healthcare quality/efficiency.

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• Budget 2024
• Goods and Services Tax

Services under Reverse Charge Mechanism (RCM) updated till 20-08-2023

Stay updated on Services under Reverse Charge Mechanism (RCM) with the latest table till 21-08-2023. Explore categories, suppliers, and recipients per Notification No. 13/2017.

Notification No. 13/2017-Central Tax (Rate), issued by the Government of India’s Ministry of Finance, introduces provisions related to the Central Goods and Services Tax Act, 2017. This notification outlines categories of services subject to reverse charge and specifies the suppliers and recipients involved.

Table on Services under Reverse Charge Mechanism (RCM) updated till 21-08-2023

Explanation .- For purpose of above,-

(a) The person who pays or is liable to pay freight for the transportation of goods by road in goods carriage, located in the taxable territory shall be treated as the person who receives the service for the purpose of this notification.

 (b) “Body Corporate” has the same meaning as assigned to it in clause (11) of section 2 of the Companies Act, 2013.

(c) the business entity located in the taxable territory who is litigant, applicant or petitioner, as the case may be, shall be treated as the person who receives the legal services for the purpose of this notification.

(d) the words and expressions used and not defined in this notification but defined in the Central Goods and Services Tax Act, the Integrated Goods and Services Tax Act, and The Union Territory Goods and Services Tax Act shall have the same meanings as assigned to them in those Acts.

(e) A “Limited Liability Partnership” formed and registered under the provisions of the Limited Liability Partnership Act, 2008 (6 of 2009) shall also be considered as a partnership firm or a firm.

(f) “insurance agent” shall have the same meaning as assigned to it in clause (10) of section 2 of the Insurance Act, 1938 (4 of 1938).

(g) “renting of immovable property” means allowing, permitting or granting access, entry, occupation, use or any such facility, wholly or partly, in an immovable property, with or without the transfer of possession or control of the said immovable property and includes letting, leasing, licensing or other similar arrangements in respect of immovable property.’

(h) provisions of this notification, in so far as they apply to the Central Government and State Governments, shall also apply to the Parliament, State Legislatures, Courts and Tribunals

(i) The term “apartment” shall have the same meaning as assigned to it in clause (e) under section 2 of the Real Estate (Regulation and Development) Act, 2016 (16 of 2017).

(j) the term “promoter” shall have the same meaning as assigned to it in clause (zk) under section 2 of the Real Estate (Regulation and Development) Act, 2016 (16 of 2017).

(k) the term “project” shall mean a Real Estate Project (REP) or a Residential Real Estate Project (RREP);

(l) “the term “Real Estate Project (REP)” shall have the same meaning as assigned to it in in clause (zn) of section 2 of the Real Estate (Regulation and Development) Act, 2016 (16 of 2016).

(m) The term “Residential Real Estate Project (RREP)” shall mean a REP in which the carpet area of the commercial apartments is not more than 15 per cent. of the total carpet area of all the apartments in the REP.

(n) “floor space index (FSI)” shall mean the ratio of a building’s total floor area (gross floor area) to the size of the piece of land upon which it is built.                                                       

(9A of Table)

(Declaration to be filed by an author for exercising the option to pay tax on the “supply of services by an author by way of transfer or permitting the use or enjoyment of a copyright covered under clause (a) of sub-section (1) of section 13 of the Copyright Act, 1957 relating to original literary works to a publisher” under forward charge on or before 31.10.2019 for the option to be effective from 1.11.2019  or  before the commencement of any Financial Year for the option to be effective from the commencement of that Financial Year.)

Reference No. ___________________

Date ____________

____________________

(To be addressed to the jurisdictional Commissioner)

1. Name of the author:

2. Address of the author:

3. GSTIN of the author:

Declaration

1. I have taken registration under the Central Goods and Services Tax Act, 2017 (12 of 2017), and I hereby exercise the option to pay central tax on the service specified against serial No. 9A in column (2) of the Table in the notification No. 13/2017 – Central Tax (Rate), dated the 28th June, 2017, supplied by me, under forward charge in accordance with section 9 (1) of CGST Act, and to comply with all the provisions of CGST Act, 2017 (12 of 2017) as they apply to a person liable for paying the tax in relation to the supply of any goods or services or both;

2. I understand that this option, once exercised, shall not be allowed to be changed within a period of 1 year from the date of exercising the option and shall be valid, at least, till the end of Financial Year following the year in which it is made.

Signature ___________________

Name _______________________

GSTIN _________________

Place __________________

Date __________________

Annexure II

(Declaration to be made in the invoice by the author exercising the option to pay tax on the “supply of service by an author by way of transfer or permitting the use or enjoyment of a copyright covered under clause (a) of sub-section (1) of section 13 of the Copyright Act, 1957 relating to original literary works to a publisher” under forward charge.)

I have exercised the option to pay central tax on the service specified against serial No. 9A in column (2) of the Table in the notification No. 13/2017-Central Tax (Rate) dated 28th June, 2017 under forward charge.

Annexure III

I/we have taken registration under the CGST Act, 2017 and have exercised the option to pay tax on services of GTA in relation to transport of goods supplied by us from the Financial Year ____under forward charge and have not reverted to reverse charge mechanism.

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RCM Company क्या है? | RCM Business की पूरी जानकारी

आज के इस लेख में हम एक भारतीय डायरेक्ट सेलिंग कंपनी के बारे में जानकारी देंगे। जो पिछले 2 दशकों से भारत में काम कर रही है, और कई ऊंच-नीच से निकली है।

इस लेख में आपको RCM Company Profile, इसके इतिहास (History), बिज़नेस प्लान (Business Plan), इनकम प्लान (Income Plan) और प्रॉडक्ट (Products) के बारे में जानकारी देंगे। अंत में हमने कुछ अक्सर पूछे जाने सवाल (FAQ) भी डाले है, जिससे आपके मन में, जो भी सवाल है, वो दूर हो जाए।

तो चालिए बिना किसी देर के शुरू करते है।

RCM Kya Hai?

RCM की फुलफोर्म Right Concept Of Marketing है, जो Fashion Suitings Private Limited के अंतर्गत आती है और यह अप्रैल, 1988 में MCA के अधीन RoC-जयपुर, राजस्थान से रजिस्टर है।

RCM ने अपना MLM प्लान सन 2000 में चालू किया था, जो आज भी चल रहा है।

करुण जैन कछार और तिलोक चंद छाबरा इस कंपनी के वर्तमान डायरेक्टर है और इसका ऑफिस भीलवाड़ा, राजस्थान में है।

RCM कंपनी 2011 में स्थापित FDSA की फाउंडर मेंबर है। FDSA Member List में अभी 25 के आस-पास डायरेक्ट सेलिंग कंपनी है, जिसमें My Recharge , Mi Lifestyle , Ok Life Care और AWPL बड़े नाम है।

RCM Vs Rajasthan State Government

अपनी शुरुवात के पहले दशक में RCM बहुत अच्छे से विकसित हो रही थी। लेकिन 2011 के अंत में RCM को बड़ा नुकसान हुआ।

राजस्थान में ही, गोल्ड सुख नामक कंपनी ने 1.5 लाख लोगों के साथ 200 करोड़ से ज्यादा का घोटाला किया था। जो 18 महीने में 1.5 गुना पैसा रिटर्न करने का वादा करती थी।

इसके चलते राजस्थान में अन्य MLM कंपनी पर भी छापा पड़ा और दिसंबर, 2011 में RCM को बंद कर दिया गया।

उस समय सरकार के पास ठोस गाइडलाइन सही डायरेक्ट सेलिंग कंपनी और पिरामिड स्कीम में अंतर करने के लिए नहीं थी, जिसके कारण RCM को यह नुकसान झेलना पड़ा।

RCM प्रमोटर ने फिर अगले 10 महीने तक कंपनी का साथ दिया और इसी बीच दिल्ली और जयपुर में कंपनी फिर शुरू करने के लिए धरने दिए।

अंत में अक्टूबर, 2012 में अशोक गहलोत की सरकार ने राजस्थान राज्य डायरेक्ट सेलिंग गाइडलाइन जारी की गई और RCM फिर से शुरू हुई।

बहुत कम कंपनियां ऐसा कर पाती है, जो हमारे सिस्टम के खिलाफ चुनौती रखें और सफल हो सके।

आज के समय में RCM भारत में मौजूद लीगल डायरेक्ट सेलिंग कंपनी में से एक है।

RCM Company Details

RCM Business Plan

RCM एक प्रॉडक्ट आधारित डायरेक्ट सेलिंग कंपनी है। अन्य MLM कंपनी की तरह कोई भी व्यक्ति RCM से बतौर डायरेक्ट सेलर जुड़ सकता है।

RCM डायरेक्ट सेलर को 2 काम मुख्य करने पड़ते है,

1. प्रॉडक्ट बिक्री

RCM से जुड़ने के बाद प्रॉडक्ट खरीदना बेहद जरूरी है। 1,000 रुपये के प्रॉडक्ट खरीदने के बाद ही Sponsor की उपाधि मिलती है और आगे MLM प्लान पर काम कर सकते है।

इसके अतिरिक्त डायरेक्ट सेलर को प्रॉडक्ट MRP से कम कीमत DP पर मिलते है। इस अनुसार डायरेक्ट सेलर प्रॉडक्ट को आगे MRP पर बेचकर रिटेल प्रॉफिट कमा सकते है।

2. रिक्रूटमेंट

दूसरा और महत्वपूर्ण काम RCM डायरेक्ट सेलर को करना होता है, वो रिक्रूटमेंट है। इसके अंतगर्त डायरेक्ट सेलर को अपने जैसे ही अन्य लोगों को बतौर डायरेक्ट सेलर RCM से अपनी डाउनलाइन में जोड़ना होगा।

इससे जो लोग डाउनलाइन में प्रॉडक्ट खरीदेंगे, उसका कुछ प्रतिशत मुनाफा अप-लाइन को भी मिलेगा।

याद रखिये, आपको पैसे लोगो को जोड़ने पर नहीं मिलते है। बल्कि जब आपसे जुड़े लोग कुछ प्रॉडक्ट खरीदते है, तो इनकम प्लान अनुसार आपको मुनाफा होगा।

RCM Products

RCM के प्रॉडक्ट की बात की जाए, तो इस कंपनी के पास 250 से 300 प्रॉडक्ट है, जिसमे FMCG, पर्सनल केअर, हेल्थ केअर, होम केअर, इलेक्ट्रिक प्रॉडक्ट मौजूद है।

RCM के पास Nutricharge नामक वेलनेस प्रॉडक्ट रेंज भी है, जिसका विज्ञापन अमिताभ बच्चन से कराया गया है।

कीमत अनुसार RCM के प्रॉडक्ट अन्य MLM कंपनी जैसे Herbalife, Forever Livings और Amway से ज्यादा किफ़ायती है। RCM प्रॉडक्ट पैकेजिंग से दिखने में भी क्वालिटी वाले लगते है।

आप RCM के सभी प्रॉडक्ट, उनकी कीमत और BV के बारे में जानकारी नीचे दी लिंक पर क्लिक करके देख सकते है।

• RCM Products Price List

RCM Income Plan

RCM इनकम प्लान के बारे में जानने से पहले हमें इसके एक मुख्य पहलू के बारे मे जानना चाहिए, जो कि RCM में BV के नाम से जानी जाती है।

BV का फुल फॉर्म Business Volume होती है। यह BV, RCM कंपनी की एक मुद्रा यूनिट हैं। BV के द्वारा एक RCM डायरेक्ट सेलर अपनी आय को निकाल सकता है।

BV हर RCM प्रॉडक्ट पर पहले से निर्धारित होती है। जो कि डायरेक्ट सेलर को हर खरीद अनुसार मिलती है।

RCM अपने डायरेक्ट सेलर को तीन प्रकार की इनकम प्रदान करती है, जो कि निम्नलिखित हैं,

• Performance Bonus.
• Royalty Income.
• Technical Bonus

ऊपर दी गई सभी प्रकार की इनकम को विस्तार से समझते हैं।

1. Performance Bonus

इस इनकम के अनुसार RCM कंपनी अपने डायरेक्ट सेलर को निश्चित BV पर निश्चित प्रतिशत की इनकम प्रदान करती हैं।

नीचे दिए गए टेबल के द्वारा आप यह देख सकते हैं, कि कितने BV तक RCM द्वारा कितना प्रतिशत इनकम प्रदान किया जाता है।

उदाहरण: मान लीजिए अगर कोई रमेश नाम का RCM डायरेक्ट सेलर 5,000 या इससे BV कंपनी ज्यादा करता है। तो ऊपर दिए गए चार्ट द्वारा आप देख सकते हैं, कि उसका लेवल 12 प्रतिशत पर आएगा और इस प्रकार RCM द्वारा उसे 5,000 BV का 12 प्रतिशत यानी 600 रुपये का परफॉर्मेंस बोनस प्रदान किया जाएगा।

2. Royalty Bonus

Royalty Bonus के अनुसार RCM अपने डायरेक्ट सेलर को 3% से 8% तक की इनकम प्रदान करती है।

इस इनकम को पाने के लिए RCM डायरेक्ट सेलर को कुछ शर्ते पार करनी होती है, जो कि निम्नलिखित है।

• अगर एक RCM डायरेक्ट सेलर को 3 प्रतिशत रॉयल्टी इनकम चाहिए, तो उसे अपने मेन लेग में 3,50,000 BV तथा अन्य लेग में 1,15,000 BV का बिजनेस करना अनिवार्य है। मेन लेग अर्थात वो लेग जिसमें सबसे ज्यादा प्रॉडक्ट खरीद हुई हो।
• अगर एक RCM डायरेक्ट सेलर को 4.5 प्रतिशत रॉयल्टी इनकम चाहिए, तो उसे अपने मेन लेग में 3,50,000 BV तथा अन्य लेग में 1,70,000 BV का बिजनेस करना अनिवार्य है।
• अगर एक RCM डायरेक्ट सेलर को 6 प्रतिशत रॉयल्टी इनकम चाहिए, तो उसे अपने मे मेन लेग में 3,50,000 BV तथा अन्य लेग में 2,60,000 BV का बिजनेस करना अनिवार्य है।
• अगर एक RCM डायरेक्ट सेलर को 8 प्रतिशत रॉयल्टी इनकम चाहिए, तो उसे अपने मेन लेग में 3,50,000 BV व अन्य लेग में भी 3,50,000 BV का बिजनेस करना अनिवार्य है।

यहाँ कुछ बिन्दु है, जो ध्यान में जरूर रखें।

• Royalty Income के लिए सालाना 1500 BV से ज्यादा की पर्सनल खरीद होनी चाहिए।
• अगर किसी व्यक्ति के पास मेन लेग (3,50,000+ BV ) के साथ-साथ एक अन्य लेग में 3,50,000+ BV और एक लेग में 1,15,000+ BV है, तो उसे दो लेग (3,50,000+ की) पर Royalty Income मिलेगी।

3. Technical Bonus

Technical Bonus के रूप मे RCM कंपनी अपने डायरेक्ट सेलर को कंपनी के कुल BV टर्नओवर में से 1 से 5 तक प्रतिशत बांटती है।

Technical Bonus को पाने के लिए कुछ शर्ते हैं, जो कि निम्नलिखित है:

• Technical Bonus इनकम को प्राप्त करने के लिए RCM डायरेक्ट सेलर को हर महीने 1500 BV का प्रोडक्ट पर्सनली खरीद करना अनिवार्य है। यह 1500 BV का पर्सनल खरीद RCM डायरेक्ट सेलर को उस साल करना होता है, जिस साल वह Technical Bonus पाना चाहते हो।
• Technical Bonus पाने के लिए RCM डायरेक्ट सेलर को 8% रॉयल्टी इनकम लगातार 3 महीने के लिए पाना अनिवार्य है, और यह कार्य करके एक डायरेक्ट सेलर Technical Bonus पाने के लिए योग्य बन जाता है।
• जब किसी RCM डायरेक्ट सेलर के मेन लेग के अलावा किसी अन्य लेग में 5,00,000 BV से ज्यादा का बिजनेस होता है, तब डायरेक्ट सेलर अपने उस अन्य अलग से टेक्निकल बोनस पाता है।
• एक डायरेक्ट सेलर को Technical Bonus मेन लेग में जितनों को भी जितना यह बोनस मिल रहा है, उसमें से घटाकर दिया जाता है।

RCM से जुडने के लिए आपको किसी Sponsor/Upline की जरूरत होती है। जिनके नीचे यानि डाउनलाइन में आपको जुड़ना होगा। इसके लिए आप किसी भी मौजूदा RCM डायरेक्ट सेलर से संपर्क कर सकते है।

डायरेक्ट सेलिंग गाइडलाइन के कारण अब किसी भी MLM कंपनी में जुडने की फीस नहीं देनी होती है। लेकिन अब प्रॉडक्ट खरीदने की जरूरत होती है, RCM से आपको औसतन 1000 रुपये के प्रॉडक्ट शुरू में लेने होंगे।

RCM से जुडने के लिए आपके पास आधार-कार्ड होना चाहिए। अगर आप 18 वर्ष के कम उम्र के है, तो अभिभावक की जानकारी दे सकते है। इसके अलावा पेन-कार्ड और बैंक अकाउंट की जानकारी देनी होगी।

हाँ, RCM में आपको लोगों को जोड़ना होता है। लेकिन ऐसा जरूरी भी नहीं है, इसमें आप सिर्फ रीटेल प्रॉफ़िट भी कमा सकते है, सिर्फ RCM के प्रॉडक्ट MRP पर आगे बेचकर। लेकिन अगर आप MLM से अच्छी इनकम चाहते है, तो लोगों को जोड़ना बेहद जरूरी है।

हाँ, RCM एक प्रमाणित MLM कंपनी है, जो प्रॉडक्ट आधारित और पूरी तरह से लीगल कंपनी है। इसे आप फ्रॉड नहीं कह सकते।

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38 thoughts on “RCM Company क्या है? | RCM Business की पूरी जानकारी”

क्या असम का भी वही हाल हो सकता है जो फ्यूचर प्लान का हुआ था क्या आरसीएम आखिरी आदमी को रॉयल्टी पहुंचाएगी क्या उसको कुछ बेनिफिट मिलेगा आज उदाहरण के तौर पर मान लो कि सारा आदमी ज्वाइन हो चुके हैं आरसीएम से तो क्या आखिरी आदमी को इनकम कैसे मिलेगी

RCM, फ्यूचर मेकर की तरह बंद तो नहीं होगी, क्युकी RCM प्रोडक्ट आधारित है. इनकम की बात करे,तो यह आपकी मेहनत और स्किल पर निर्भर करती है.

kisi ki bhe garnti nahi hai

Kabhi bhi last joining nahi ho sakta, Bharat me har ghante ya minutes me 48000 child janm lete hain, esliye eski chinta n kare,,

सुरेश भाई असम के सारा आदमी जुड़ गया,तो दूसरे प्रान्त में बिज़नेस को बढ़ाओ ,अगर वहाँ भी जुड़ गए तो और दूसरे प्रान्त में बढ़ो।और उसके बाद तो पूरी दुनिया बाकी है।

Payment tho na miligi liking use ki jarrorat ka shaman Kam damo me meliga tho

RCM से income सिर्फ प्रोडक्ट खरीदने पर होती है ना की आदमी जोडने पर अगर हर आदमी अपना महीने का किराना भरता रहेगा तो हा आखरी आदमी को भी income हर महीने आती रहेगी

Sir abadi badhna band nahi hua,jis din pura india nasbandi Kara liya aur insan kapra pahnana,namak khana chor Diya damjh lijiyga rcm ab nahi chalega

Sir , Ye to apko phle rcm ko join karna hoga. Aur fhir agar app last person rhe to apko pata chal hi jayega ki apko income kese milegi. Phle wo aakri admi to Bane.

Bhiyaa yaa RCM Mai sponsor or purposer Koon hota hai join karwa at samay Kaya fill karay please batiyaa example

Ek joining form fill karna padhega or jo aapko company se judwa rha hai, wo aapka sponser hoga. uske baad aapko company ke product kharidne hoge or unhe aage bechna hoga.. iske saath saath naye logo ko aapko company me jodkar sponser karna hoga

Rcm product are not costly # jis paise se hm traditional market se grocery lete hai aur use karte hai usi paise se hame rcm product kharidana hai aur use karne hai # its too simple other mlm company se kam price ka saman hai yaha

Rcm ka product bilkul bhi mahanga nahi kyoki rcm indian rate, indian culture, indian mentality me kam karti hai rcm is the best mlm company

Books chahi sir

RCM.call.9472768115.pegrup.hai.josari.samasya.rcm.se.hai.jo.solf.hogi.samjhaya.jaye.ga.aap.ke.aanurodh.pe.aapka.number.grup.mesamil.hoga.last.aadmi.ka.bhi.enkam.hota.hai.sar.bacha.janm.leta.hai.our.ak.bar.old.hokar.marta.hai.fir.silsila.chalta.jata.hai.ushi.tarah.hai.rcm.bussines

Hame bhi thoda kam vishvash hai

friend myself Kuldeep chauhan..

Rcm is a legal and legend market concept……..h #Healthy life # self dependent Best regards ( Kuldeep Kumar )

RCM BUSINESS IS BETTER THAN SIMPLE MARKETING..

ek bar join ho jao bas aor lage raho jis traha tum kam karoge usi traha paisa ayega ghar ka saman lena hi padta hai to kiu ma rcm se le jnha se hamko income bhi mile.jo rcm ko pahchan gaya wo ho gaya diwana

Are bhai Rcm nahi karoge to Kya karoge dost

Rcm is one of the best company since products are reasonable, qualitative and quantitative as compare to other market products… so please dont hesitate to join… and do the work seriously… it will definitely change your life….

RCM Mai ham fase dusroko kyu fasaye

Kyu kya huya aapke saath Sir asa…….. Plese Explain

Rcm me joining karne ke bad lagbhah kitne ka saman kharid sakte hai jaruri nahi ki 1000 ka saman le 2q.paisa accaunt me transfer kab hota hai hai 500 b.v.me jo paisa banta hai vah account me aajata hai ya pin genrate hone par paisa aata hai please jankari de

200 se 300 amounts hone per aap ke account me transfer money ho Jata hai

RCM me join karane ke liye kya karana hota tatha commission kaise distribution hota he . minimum Kitana BV ka saman kharidana hota he .

Koun si mlm company hain jo RCM se kam rate me products deti hain ?

RCM is the only direct company with real daily need products required according to indian culture, priced according to the normal market with best quality in the same cost range. Products are such that if any body does or does not in direct selling, doesn’t matter, they had to purchase same type of products fro. Market at higher rate. So there is never a question of loosing money for any common average income status person, which is in contrast to the other all companies.

aap ko nahi lagta ki MLM companies local market ko nast kar rahi hai. jab log MLM se saman kharidenge to local businessman kya karega. ye desh hit me nahi hai. isse beroggari aur badhegi. Lock down ke samay local vyapariyo ne hi hamari maddad ki thi , hame ye yaad rakhna chahiye.

मै आपकी बात से पूर्ण सहमत हूँ। बेशक ई-कॉमर्स, मॉल, लोकल मार्केट और MLM एक-दूसरे के विरोधी है और सबके अपने फायदे व कमी है।

Sir Rcm Company Kbhi Futur me Bnd to nhi ho skti na…..

भाई मैं आपसे RCM के बारे में पुरी जानकारी लेना पसन्द करूंगा !

Agr mai 100000 ka mal utha k sell kr du mera kitna profit hoga

Hi, RCM Me join kaise hona chahiye kiya karna hai or q?

Kese Fase Aap Mujhe Samjhayenge Aap Mujhe Bataoge

Sure apni khridari per bhi income aayga kaya

कृपया RCM के टॉप अचीवरस के बारे में आप बताये और प्रोडक्ट बेस मनी सर्क्युलेशन क्या होता है इस विषय पर भी बताये क्यूंकि आज के समय में ज्यादातर नेटवर्क मार्केटिंग कंपनी अपने उत्पाद को ऊँचे दाम पर बेचती है l

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North Carolina can switch to Aetna for state worker health insurance contract, judge rules

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RALEIGH, N.C. (AP) — In a legal fight involving two health insurance companies seeking to manage North Carolina’s public employee benefits plan, a judge ruled Monday that the plan’s board acted properly when it switched to Aetna and dropped longtime administrator Blue Cross and Blue Shield of North Carolina.

Contract costs — with health care claims included — exceed $3 billion annually.

Blue Cross has administered the State Health Plan for over 40 years. The administrator handles health care expenses for several hundred thousand state employees, teachers, their family members and retirees, ensuring claims are paid and building out a provider network. After a bid process, the plan’s trustee board voted in December 2022 to award the initial three-year contract to Aetna over Blue Cross and a unit of United Healthcare, which also competed.

Blue Cross challenged the decision, arguing that the State Health Plan erred in how it decided which company would get the contract and calling the bid process oversimplified and arbitrary. But Administrative Law Judge Melissa Owens Lassiter, who heard the contested case in February, wrote Monday that Blue Cross had not met the burden of proof necessary to show that plan leaders had acted erroneously or failed to follow proper procedures.

“The preponderance of the evidence showed that the Plan conducted the procurement carefully and thoughtfully, fairly and in good faith, and that its decisions were properly within its discretion,” Lassiter wrote in affirming the trustee board’s decision to give the award to Aetna. It’s unclear if the ruling will be appealed to Superior Court.

Blue Cross said it was disappointed in the ruling but “gratified that the court reviewed the serious questions we raised” about the State Health Plan’s proposal request process. “Blue Cross NC is honored to serve our teachers, public safety officers and state employees and will continue to provide the highest level of service throughout the current contract,” the company said in a written statement.

State Treasurer Dale Folwell, the trustee board chairman, praised the ruling, saying it had been clear that the State Health Plan “performed a well-reasoned, high-integrity, and correct procurement process for third-party administrative services.”

Aetna North Carolina market president Jim Bostian said several hundred of its employees so far have worked on implementing the contract on time “while demonstrating in court that the transition to Aetna is in the best interests of the State Health Plan and its members.”

What every insurance leader should know about cloud

The increasing use of digital tools and services, as well as the corresponding surge in data generated from digital interactions, has made technology a crucial competitive capability for insurance carriers. In that context, cloud has emerged as a generational opportunity, with leading carriers already using it to serve customers better, faster, and more efficiently.

About the authors

This article is a collaborative effort by Sanjay Kaniyar, Mathew Lee , Ani Majumder, Binu Sudhakaran, and Steve Van Kuiken , representing views from McKinsey Digital and McKinsey’s Financial Services and Operations practices.

Insurers join most organizations across all sectors in expecting to significantly ramp up adoption and migrate a growing share of their compute environment to public cloud within the next five years (Exhibit 1). That intention is reflected in the projected 32 percent annual growth in cloud services by 2025. 1 laaS + PaaS revenue, Gartner 2018 and 2020 reports; McKinsey analysis.

The most important thing to understand about cloud, however, is that it’s not a more efficient way to operate IT, but a force multiplier for generating value for the business. This reality is why it is critical for business leaders, particularly business unit CEOs and business unit heads, to understand the value at stake and what it takes to capture it. Insurers that use the cloud effectively can unlock such desirable capabilities as providing omnichannel experiences for customers, developing a diverse portfolio of integrated services, and rolling out solutions at unprecedented speeds.

Business unit CEOs understand the nuances of the business and have accountability for identifying and driving the change. They should therefore act as orchestrators of the cloud migration and coaches for the rest of the business leadership in setting bold aspirations and establishing the organizational model that enables the business to harness cloud’s full value.

Through deep discussions with insurance business unit leaders and years of experience helping them migrate to the cloud , we have found that the business units most effective in capturing cloud’s value focus on two key areas: understanding where the value in cloud lies and building a partnership between business and IT.

Would you like to learn more about Cloud by McKinsey ?

Be clear about where the value is in cloud.

Most insurers still vastly undervalue cloud’s potential. Our research shows that the EBITDA run-rate impact of cloud on the insurance sector will be $70 billion to $110 billion by 2030—in the top five of all sectors analyzed. When looking at EBITDA impact as a percentage of 2030 EBITDA, insurance is the top-ranked of all sectors, at 43–70 percent. 2 “ Cloud’s trillion-dollar prize is up for grabs ,” McKinsey Quarterly , February 26, 2021.

This value comes from two sources. 3 McKinsey analysis also identified value from a third source: pioneering, which is the use of advanced but nascent technologies that can extend cloud’s value. These developments, however, are not yet mature enough for their effect to be accurately calculated. The first is rejuvenation , which focuses on using cloud to lower costs and risk across IT and core operations. It can be predominantly driven by IT teams.

The second source of value is innovation , which focuses on harnessing the cloud to accelerate or enable the development of new revenue streams. That includes, for example, faster time to market or new-product development—using advanced analytics, IoT, and automation at scale. A close partnership between IT and business leadership is needed to drive the innovation. One insurance carrier, for example, announced a new direct-to-consumer business targeting gig-economy workers and retired baby boomers, which was made possible by a host of cloud-native services including AI-based chatbots, data services, and automated or digitized workflows.

As in most sectors, the value of cloud-facilitated innovation in the insurance industry dwarfs what’s achievable through rejuvenation.

By understanding the hierarchy of value , insurance companies can move past the proverbial low-hanging fruit, the most accessible benefits of cloud that require limited business engagement (Exhibit 2). Only a select few companies, where business leaders have led the cloud transformation in tandem with technology leaders, have been able to capture the full potential of cloud.

Those carriers that have effectively tapped the hierarchy of cloud value have realized significant benefits, including the following:

• Faster time to market. New capabilities, business features, and products can be more quickly developed, tested, and launched in cloud than in traditional environments. This advantage is particularly acute for early movers, who can respond to market changes much more quickly than their non-cloud competitors. For example, when a large, global property-and-casualty (P&C) company adopted a cloud-based policy administration platform, it was able to bring new specialty insurance products to market within three months.
• Lower cost to serve. Cloud technologies and tools enable better asset utilization and more-flexible operating models. These make existing revenue pools more profitable and help businesses access opportunities that were previously not economically viable. One investment management company developed a “cloud-native” record-keeping solution, which has improved efficiency, scalability, durability, and automation. It now has a 100 percent cloud-native architecture that can reduce the cost of computing by 30 percent and deploy workloads up to 20 times faster with greater resiliency.
• Economies of scale. Cloud can easily scale either up or down as needed, unlike on-premises data centers. Cloud provides the compute power that is needed to fully understand and make use of incredibly large data sets, such as tens of millions of claims data points. One wealth management firm is using cloud-based data and analytics algorithms to achieve industry-leading rollover rates and improving the lifetime value of clients by delivering nudges based on key life events, such as likelihood to terminate and retirement.
• Access to advanced capabilities through cloud services. Advanced cloud capabilities allow companies to generate insights that previously demanded intensive resources to develop. For example, machine learning services can be used to identify potentially fraudulent activity much faster. Tools are available that enable companies and their partners easier access to regulatory information, helping them to stay compliant at lower cost. One financial-services company has moved all servicing to cloud to use a host of cloud-native tools. This has enabled it to serve smaller customers than it could before. Costs per call are much lower because agents are far more productive when they rely on completely automated “transactional interactions,” such as the use of advanced interactive voice response, chatbots, and self-service tools. Customer satisfaction scores have increased, and agents can now spend more time with customers for more complex transactions and interactions. Insurance companies have found 12 cloud capabilities particularly relevant and useful to their business (Exhibit 3).

To increase the cloud’s business impact, major institutions are negotiating transformative partnerships with cloud service providers (CSPs) to make better use of cloud technologies.

Cloud by McKinsey Insights

Build a close working relationship between it and the business side early in the cloud journey.

In our experience, cloud transformations are most successful when they are joint efforts between business and IT, rather than purely IT-led initiatives. Such collaborations are more likely to direct efforts efficiently at the sources of business value and at business outcomes aligned to the institution’s overall goals.

In successful business–IT partnerships, IT leaders and business unit heads have worked closely with each other to educate the business—and the board —about cloud in the following ways:

• Incorporate cloud topics into strategy discussions by laying out the ways that business goals can be enabled and accelerated through cloud services—for example, by harnessing AI to improve the accuracy of predictive analytics on insurance needs. In this way, both the business and IT can build a practical understanding of cloud technologies and their business benefits. IT leaders should develop a portfolio of examples detailing how their peers leverage cloud. These activities are critical from a capability-building, business-adoption, and change-management point of view and will also help the leaders across the business visualize the “art of the possible.”
• Build excitement about the cloud and its possibilities through a joint immersion program for IT and business leaders (Exhibit 4). These immersion sessions could serve as jumping-off points for new and existing portfolios of cloud-enabled initiatives as well as lay the foundations for effective business–IT collaboration. They might include “go-and-see” visits where business leaders can learn from their peers in other institutions who have gone through similar cloud journeys. The most effective immersion programs also include a cloud learning curriculum for business leaders, with a focus on the business impact of cloud. This will help them to gain a deeper understanding of why cloud matters and how it can enable and accelerate the business value of transformation initiatives in each business domain.
• Encourage the business unit leadership team to be the change agents and evangelists for cloud within their organization and communicate the value that cloud can unlock within their areas. Successful cloud journeys involve selecting and training leaders in the business to, for example, think in terms of operating expenditures in calculating cloud spend and work with teams to develop products, and to become cloud champions to help the rest of the organization understand the business value of cloud. They also call on functional teams, such as operations, marketing, and legal, to highlight the value of cloud for their areas and how it can enhance their functions.

At one large, global life and retirement company, the CIO orchestrated a three-month cloud immersion program for the company’s top 100 business and IT leaders. This senior leadership team started off by learning the basics of cloud through field and forum exercises, went on “go-and-see” visits to two companies further along in their cloud journey, and targeted sessions with CSPs to learn about practical use cases from other industries in such specific functional areas as marketing and customer analytics. Coming out of these sessions, the leadership team identified the key cloud capabilities most relevant for them. For each capability, they assigned a go-to person, or “navigator,” from within the leadership team to help the rest of the organization quickly and efficiently advance in that capability.

It is critical for business leaders to understand the potential of cloud and inspire senior leadership to think about the “art of the possible.” It is the first step in what is often an intense learning and change-management process, but making that investment now, before individual companies are overtaken by faster-acting competitors, is essential for companies to compete effectively and sustainably.

Sanjay Kaniyar is a partner in McKinsey’s Boston office, where Binu Sudhakaran is an associate partner. Mathew Lee is a partner in the Miami office, Ani Majumder is a partner in the New York office, and Steve Van Kuiken is a senior partner in the New Jersey office.

The authors wish to thank Ritesh Agarwal, Ramnath Balasubramanian, Sven Blumberg, Mark Gu, James Kaplan, Krish Krishnakanthan, and Neha Sahgal for their contributions to this article.

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