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Four Factors that Affect the Medical Revenue Cycle

Posted By Giovanna Stahl

Revenue cycle management (RCM) is a technological tool used for both administrative tasks and clinical functions to record and organize patient claims including collected claim payments as well as denials. If this system isn’t running efficiently, then it could lead to inaccurate medical billing, which can tarnish a patient’s healthcare experience.   


A healthy medical revenue cycle management system plays an important role in building strong bonds with patients and providing the best healthcare experience. While accurate medical coding and billing makes managing the medical revenue cycle much easier, it leads to excellent patient care services. ECLAT Health Solutions is aware that accurate medical documentation and coding is the key to maintaining a quality revenue cycle management system. As one of the top medical billing companies in the Northern Virginia area, it is our duty to help educate health providers and individuals on each and every aspect of medical coding and billing. Four factors that can affect the front-end and middle process of the medical revenue cycle are listed below.

1. Incomplete or Incorrectly Recorded Patient Information

Medical billing begins with the first health provider and patient encounter. Staff must properly gather all patient information to ensure billing procedures go smoothly. Collecting patient information correctly the first time around prevents patient redundancies and delays in claims reimbursement and rejections. If health insurance or demographic information, such as patient eligibility, isn’t recorded accurately, then it generally takes much longer to correct the mistake through the healthcare organization.    

2. Increased Patient Financial Responsibility

Due to a patient financial responsibility 11% increase in 2017, healthcare organizations and providers have noticed that payment collection problems have heightened. As an insufficient amount of information is being provided to patients, individuals are unable to provide payments in full or on time because of unexpected costs and fees. To make medical billing more simple to understand, both healthcare providers and patients must have a medical billing system that is straightforward and easy to understand.  

3. Manual Record Keeping  

The medical billing and coding system is far more complex than some people may think, and it’s understandable as to why there are as many medical billing issues for health providers and patients. With this said, there are still health organizations out there that manually enter claims and denials, which leaves room for many mistakes. If providers were to implement an automated medical billing and claims process, they would be able to have a more efficient system that would streamline patient healthcare.

4. Inaccurate Medical Coding

Inaccurate medical coding is one the most common medical billing errors for health organizations to date. Quality patient care is dependent on accurate medical documentation and coding. Improper coding can badly affect providers and patients, which can lead to patient mistreatment, claim denials, and much more. This can be avoided with the help of a highly-trained and certified medical billing and coding company because the medical billing and coding process is complex and a great deal for a single provider to handle on its own.

Speak to a Revenue Cycle Management Specialist at ECLAT

Health information management directors are often burdened with the task of overseeing entries made to ensure quality reports are carried out. Let ECLAT facilitate this process by having a dedicated medical coding and billing specialist in charge to ensure proactive quality measures are established and maintained. If your healthcare organization in Northern Virginia is in need of assistance with improving your current medical revenue cycle management system, ECLAT Health Solutions will be able to do just that. With an efficient health information management system and excellent patient services, healthcare providers everywhere can increase their medical revenue cycle and maintain a healthy financial situation.

Speak with ECLAT Health Solutions today! Contact us at (703) 665-4499 to schedule a meeting.

Learn more about ECLAT Health Solutions services here.

Tags: RCM, Revenue Cycle Management