Healthcare Revenue Cycle Management: Introduction
- Healthcare revenue cycle management is the accounting procedure to manage clinical and administrative functions associated with revenue generation, payment, and claim processing.
- The healthcare revenue cycle management process begins when a patient books an appointment to pursue medical services and ends when all the payments and claims have been collected from the patient
- Healthcare revenue cycle management supports running a successful medical practice because it helps to provide an efficient and accurate billing process in the healthcare domain.
- Healthcare revenue cycle management helps to reduce the amount of time between providing a service and receiving payments by interacting with electronic health records and billing systems. Healthcare organizations use a coding system and centralized billing to enable clinical process, compliance, and reimbursement.
Healthcare Revenue Cycle Management Market: Dynamics
Healthcare Revenue Cycle Management Market: Key Drivers
- Healthcare revenue cycle management helps to reduce human errors in the claim submission process. Healthcare data professionals can run healthcare management software to automatically scan for mistakes and send alert errors.
- It also enables patient payments by sending billing reminders via text message or email. In this message, a direct link to payment gateways is offered by using electronic data interchange tools. When linked with patient health record structures, financial managing tools can maintain patient interaction, from scheduling and intake forms to billing and insurance eligibility. These result in a streamlined process that improves patient satisfaction and speeds revenue recognition.
- Healthcare revenue cycle management programs help providers transition to value-based settlement practice. By evaluating data generated through combined records and billing systems, the provider can diagnose trends in patient populations and find areas of need.
Impact of COVID-19 on the Global Healthcare Revenue Cycle Management Market
- The hospital and healthcare industry is witnessing a growth in investment for advanced medical solutions during the COVID-19 period to maintain the payment records of patients. Hospitals are facing issues with management of patient records due to an increase in COVID-19 virus-infected patients. Healthcare revenue cycle management software also helps a hospital to check the claim eligibility of patients, which reduces the operational time of the hospital during the pandemic.
- Demand for healthcare revenue cycle management software is increasing during the COVID-19 pandemic situation due to an increase in demand for healthcare solutions and advanced patient management across all regions
North America to Hold Major Share of the Global Healthcare Revenue Cycle Management Market
- North America dominated the global healthcare revenue cycle management market in 2020. The U.S. is a key market in the adoption of new technologies. Strong financial position enables the country to invest heavily in the adoption of leading tools and technologies to ensure business operations.
- The global healthcare revenue cycle management market in Asia Pacific is projected to expand at a rapid pace during the forecast period due to a surge in investment by major players to provide business solutions across the region and also due to a rise in awareness regarding the benefits of healthcare revenue cycle management in Asia Pacific.
Key Players Operating in the Global Healthcare Revenue Cycle Management Market
- 4 medica, Inc.
4 medica, Inc. was founded in California, U.S. in 1998. The company provides a business in laboratories & imaging centers, hospital & healthcare, healthcare plans & ACOs, and HIEs & HINs systems The Company has expertise in healthcare revenue cycle management and solutions.
- Abeo Management Corporation
Abeo Management Corporation is a leading healthcare revenue cycle management company that offers real-time tracking for clinical documentation and discrepancies. The company delivers revenue integrity insights on reimbursement, compliance, and operational efficiency.
Other key players operating in the global healthcare revenue cycle management market includes Ability Network, Inc., Accenture, Access Healthcare, AccessOne MedCard, Inc., AccuReg, ACI Worldwide, CAN Healthcare, AdvantEdge Healthcare Solutions, Advantmed, LLC, Advantum Health, Advicare, MediReyy, MedKoder, LLC, Med-Metrix LLC, and Medphine.
Global Healthcare Revenue Cycle Management Market: Research Scope
Global Healthcare Revenue Cycle Management Market, by Deployment
Global Healthcare Revenue Cycle Management Market, by Function
- Medical Coding & Billing
- Patient Insurance Eligibility Verification
- Claims & Denial Management
- Electronic Health Record
- Payment Remittance
- Clinical Documentation Improvement
- Others Functions
Global Healthcare Revenue Cycle Management Market, by End-user
- Other End-users
Global Healthcare Revenue Cycle Management Market, by Region
- North America
- Rest of North America
- Rest of Europe
- Asia Pacific
- South Korea
- Rest of Asia Pacific
- Middle East & Africa
- South Africa
- Rest of Middle East & Africa
- South America
- Rest of South America
This study by TMR is all-encompassing framework of the dynamics of the market. It mainly comprises critical assessment of consumers' or customers' journeys, current and emerging avenues, and strategic framework to enable CXOs take effective decisions.
Our key underpinning is the 4-Quadrant Framework EIRS that offers detailed visualization of four elements:
- Customer Experience Maps
- Insights and Tools based on data-driven research
- Actionable Results to meet all the business priorities
- Strategic Frameworks to boost the growth journey
The study strives to evaluate the current and future growth prospects, untapped avenues, factors shaping their revenue potential, and demand and consumption patterns in the global market by breaking it into region-wise assessment.
The following regional segments are covered comprehensively:
- North America
- Asia Pacific
- Latin America
- The Middle East and Africa
The EIRS quadrant framework in the report sums up our wide spectrum of data-driven research and advisory for CXOs to help them make better decisions for their businesses and stay as leaders.
Below is a snapshot of these quadrants.
1. Customer Experience Map
The study offers an in-depth assessment of various customers’ journeys pertinent to the market and its segments. It offers various customer impressions about the products and service use. The analysis takes a closer look at their pain points and fears across various customer touchpoints. The consultation and business intelligence solutions will help interested stakeholders, including CXOs, define customer experience maps tailored to their needs. This will help them aim at boosting customer engagement with their brands.
2. Insights and Tools
The various insights in the study are based on elaborate cycles of primary and secondary research the analysts engage with during the course of research. The analysts and expert advisors at TMR adopt industry-wide, quantitative customer insights tools and market projection methodologies to arrive at results, which makes them reliable. The study not just offers estimations and projections, but also an uncluttered evaluation of these figures on the market dynamics. These insights merge data-driven research framework with qualitative consultations for business owners, CXOs, policy makers, and investors. The insights will also help their customers overcome their fears.
3. Actionable Results
The findings presented in this study by TMR are an indispensable guide for meeting all business priorities, including mission-critical ones. The results when implemented have shown tangible benefits to business stakeholders and industry entities to boost their performance. The results are tailored to fit the individual strategic framework. The study also illustrates some of the recent case studies on solving various problems by companies they faced in their consolidation journey.
4. Strategic Frameworks
The study equips businesses and anyone interested in the market to frame broad strategic frameworks. This has become more important than ever, given the current uncertainty due to COVID-19. The study deliberates on consultations to overcome various such past disruptions and foresees new ones to boost the preparedness. The frameworks help businesses plan their strategic alignments for recovery from such disruptive trends. Further, analysts at TMR helps you break down the complex scenario and bring resiliency in uncertain times.
The report sheds light on various aspects and answers pertinent questions on the market. Some of the important ones are:
1. What can be the best investment choices for venturing into new product and service lines?
2. What value propositions should businesses aim at while making new research and development funding?
3. Which regulations will be most helpful for stakeholders to boost their supply chain network?
4. Which regions might see the demand maturing in certain segments in near future?
5. What are the some of the best cost optimization strategies with vendors that some well-entrenched players have gained success with?
6. Which are the key perspectives that the C-suite are leveraging to move businesses to new growth trajectory?
7. Which government regulations might challenge the status of key regional markets?
8. How will the emerging political and economic scenario affect opportunities in key growth areas?
9. What are some of the value-grab opportunities in various segments?
10. What will be the barrier to entry for new players in the market?
Note: Although care has been taken to maintain the highest levels of accuracy in TMR’s reports, recent market/vendor-specific changes may take time to reflect in the analysis.