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Analytics Intern · Revenue Cycle Management

What Revenue Cycle Management actually is.

Revenue Cycle Management (RCM) is the end-to-end process of tracking a patient through the healthcare system, from scheduling to final payment. It's treated as a cycle rather than a straight line. What happens in one encounter shapes how the next one is handled. Often cited as a $29B+ industry, and essential to how every healthcare organization actually gets paid.

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Risk Adjustment breaks out herePre-RegistrationRegistrationChargeCaptureUtilizationReviewCodingClaimsSubmissionRemittanceProcessingInsuranceFollow-UpPatientCollectionsRevenueCycle

Stage 01 / 9

Pre-Registration

Verify eligibility before the visit

Verify patient eligibility, insurance coverage, and gather key demographics (name, date of birth, insurance ID) prior to the visit. Early validation reduces delays and denials downstream. A missing or invalid prior authorization identified here can prevent a denial later in the cycle.

Example: Confirm insurance before a scheduled surgery.