UHS Billing Services operates the revenue cycle management (RCM) activities. RCM is the financial process, utilizing medical billing software, that healthcare facilities use to track patient care from registration and appointment scheduling to the final payment of a balance.
RCM unifies the business and clinical sides of healthcare by coupling administrative data, such as a patient's name, insurance provider and other personal information, with the treatment a patient receives and their healthcare data.
Communicating with health insurance companies is a key activity of Billing Services. When a patient schedules an appointment, UHS Patient Registration staff typically check the patient's reported insurance coverage before the visit. After an insured patient receives treatment for a given condition and supplies any applicable copayment, a healthcare provider or coder categorizes the nature of the treatment according to ICD-10 codes. The hospital or care facility then sends the care summary with ICD and Current Procedural Technology codes to the patient's insurance company to see what portion of the care will be covered by insurance, with the patient billed for the remainder.
The revenue cycle includes all the administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue.