Every hospital requires a medical billing company which manages the Revenue Cycle. Shortly, RCM (Revenue Cycle Management) is the financial process, utilizing medical billing software, they use to track patient’s care episodes from registration and appointment scheduling to the final payment of a balance.
This very easily depicts that the Medical Billing team has various tasks to do under it for which a team of experts has to assimilate and functions with individual as well as team effort.
RCM include Referrals and Authorizations. And the coordinators under it, take care of each part of the processing with the help of the utilization of management department that reassures and confirms the liability of the company. Referrals and Authorization showcase that if any part in the process is missing then in that case either the rendering doctor have to adjust the claim or the patient will have to make the payment. Notably MDCare e-services have a strong team of Referral and Authorization that keeps track and follows up the processing and development in each level and part of the system.
Nowadays it is one of the important jobs to do in every physician’s office, whether they are a PCP (Primary Care Physician) or a Specialist Physician’s office. (N.B. Referral is a process wherein Primary Care Physician (PCP) refers a patient to a participating specialist provider when it is medically necessary, however Authorization is a formal process to get the approval from the Insurance, if a particular service need an authorization.)