Revenue Cycle Management in Healthcare Explained

[@EyadGharaibeh]

I am a GI fellow who is extremely passionate about simply understanding the business that I work for. This video has been one of the most informative videos I have ever seen on youtube. 99% of doctors do not know what a RCM is and have no idea how a hospital makes money. Thank you so much for sharing this insight! Definitely subscribed and taking notes on your videos!

[@ahealthcarez]

Super! Thank you for watching.

[@rufussweeneymd]

Psych intern here. Same feelings. Glad I’m not alone in puzzling through this stuff.

[@Brightmdapps]

Internal medicine doc 9 years into practice and never been formally taught this until today. Thanks!

[@OneTwo-jv8oq]

Thank you for your commitment, sharing your knowledge and talents, to help us all better understand allocation of 4.5 trillion dollars annually!

[@ahealthcarez]

Thank YOU for watching.

[@OlufunshiAyo]

I am currently taking my MBA in Healthcare management and this video is golden!! We discussed about the revenue cycle in one of my classes. This just made me understand it more... I love Healthcare!!!

[@ahealthcarez]

Thank you for watching and for your feedback.

[@changyang6775]

Excellent story of the RCM, especially the comments you made! I hope more physicians could be powered by these knowledges and ethics you have.

[@ahealthcarez]

Thank you for your feedback.

[@DeWayneTooson]

Excellent! Absolutely brilliant presentation!

[@ahealthcarez]

Thank you for your support.

[@vamshianand]

Thank you for sharing this wonderful video! No one has ever explained RCM to me this clearly in the 5+ years I have been working in the industry. This is absolutely insightful.

[@ahealthcarez]

Thank you for watching.

[@colleenwrites]

Thank you for sharing your experience. This is another example of why hiring people passionate in their work is crucial. Revenue Cycle Management is truly a song that never ends between Provider and Payer.

[@ahealthcarez]

Thank you for watching and sharing your thoughts.

[@JuliaCA83]

You explained it well better than my trainer in my medical coding program course. Thanks for breaking it down. ♻👍

[@ahealthcarez]

Thank you for watching.

[@komilakarimova8919]

I came to US as an International student and was so confused with how health insurance and billing system works. I work in healthcare after my graduation and find it important to understand the financing and RCM. Thank you for simple and informative video!

[@ahealthcarez]

Thank you for watching and for your comment.

[@lourdesbeltran3225]

Thank you for super simplifying a very complex process !! 👍

[@ahealthcarez]

Thank you for watching.

[@smc4229]

Appreciate you breaking this down. What an efficient system!

[@ahealthcarez]

Thank you for watching.

[@garrywelch4041]

thank you Eric for educating us all on this- what a dog's dinner ! Another important issue you have helped us understand. Makes sense that we are so stuck in US healthcare: "Show me the incentives and I will show you the behavior": a relevant quote from the late Charlie Munger at Berkshire Hathaway.

[@ahealthcarez]

Thank you for your feedback.

[@vitalhealth4203]

I'm working in US Healthcare company from India... It is the one of the most important questions when interviewer asked questions in interview... You made it understand very clearly.. Thank you... We want more videos regarding denials and healthcare knowledge 😊

[@ahealthcarez]

Super. Thank you for watching.

[@JChan-ru2hf]

Hospital RCM manager here. One of my biggest challenges is the education that coders get. They have certificates and they’re asked to read and decipher notes written by doctors. The merging of clinical and clerical is challenging in healthcare.

[@ahealthcarez]

Thank you for sharing your experience.

[@harrychristan3452]

Appreciated for your enthusiastic explanation.

[@ahealthcarez]

Thank you for watching.

[@SteveSchutzer]

Another fabulous episode by Dr Bricker. I did have to chuckle a bit and marvel at the ridiculous complexity of RCM. I am co-founder of a healthcare startup. We get paid by a BUCHAH TPA for services to one of our clients. We get paid by a "case rate" for a bundle of services. We have only ONE code and ONE case rate (that's it) and yet the insurance company cannot get it right - and our days in AR keep growing. One code and one reimbursement! Is this by accident I ask?

[@ahealthcarez]

Good question. No. So frustrating. Thank you for watching.

[@akshayshekhawat1615]

Thanks! This was really informative

[@ahealthcarez]

Thank you for your comment.

[@shivamraja7671]

Incredible once again

[@ahealthcarez]

Thank you.

[@fhd89234n8f43n7]

Amazing video and so clearly explained!! I want to meet this guy sometime.

[@ahealthcarez]

Keep your expectations low. 😉 Thank you for watching.

[@nathanmartinez8864]

Thanks for this and if you ever want to go into even more details about the out of network claims process and or the journey of the automation of claims submissing from EHR-Clearinghouse would love to talk! Great job again!

[@ahealthcarez]

Thank you for your support.

[@sandysomaram7898]

Thank you sir awesome 👍

[@ahealthcarez]

Thank you for watching.

[@somarble]

It would be interesting to see this ecosystem map of interactions between providers, payers, and other entities involved.

[@ahealthcarez]

Thank you for your suggestion.

[@somarble]

@@ahealthcarez seems like there are many players yet making things more complicated and error-prone rather than helping providers get paid

[@SpecialK711]

Excellent summary of an unnecessarily complicated process that has, in fact, become increasingly costly & burdensome in the past 30 yrs. I can't blame physicians one bit for deferring this administrative mess to a hospital group, but the flip side is that they also relinquish a disparate share of their autonomy. This can only change in their favor @ the legislative level.

[@ahealthcarez]

Thank you for sharing your perspective.

[@kdowning79]

As long as the insurance company lobbyists have control through regulatory capture of the legislative process, physicians will always be at a disadvantage and stymied progress will remain steadfast.

[@albertjstanley]

This was a super insightful video for me, as I'm very new to this field. I was wondering what you've seen being done to speed up the very manual claim submission process you described? It struck out to me as a place where generative AI could automate the process of responding to denied and delayed claims (perhaps using Large Language Models to generate automated responses whether online or over the phone). I would imagine that helping automate these processes could reduce the accounts receivable days. Thanks so much for the content! Came at just the right time.

[@ahealthcarez]

Yes. Many groups are working on that.

[@xCristianAndres]

Hi Albert! Are you currently working in Revenue Cycle?

[@JAMEST-tl1uj]

Dr Bricker I really enjoy your work. You have taught me a lot in a short time. My perspective is a little different than most. I have a Ph.D in Accountancy from, a place you are familiar with, the University of Illinois I am writing a paper on control system biases in the US medical industry related to the use of fee-for-service reimbursements. Would it be possible to get citations of your sources for your videos that I could use in my paper? E,G, You cite 29B in administration costs with a 13% growth rate. I can use this to motivate my discussion. Keep up the good work.

[@roy_abir33]

Very helpful video. But please use Link Suggestions for each Steps next time onwards, because I found it difficult to trace back to the point I need, and had to rewind or fast forward that eventually took much time to find out. Or else it's really very explanatory and serves the purpose for those who are looking for a quick review or revision to harness their knowledge about RCM in a better way. Keep up the great work 🎉❤

[@rockstararjun7228]

Hi i have 6 years experience in us health care claims ( payer / provider side) i am ar analysis level 2 how to got a jobs in USA or ( other country) because i am india pls guide me

[@otiliapopescu9264]

How would you optimise this cycle?

[@ahealthcarez]

Great question.

[@hizbawiginbarginbarghinda3872]

👍

[@asdfaam]

What product would you like to see in RCM that would solve a lot of problems

[@ahealthcarez]

Good question. It’s not a product, but rather a financial relationship… Providers going at risk and collecting a constant stream capitated payments. I.e. Not fee-for-service.

[@asdfaam]

​@@ahealthcarez what's stopping this from happening?

[@Nerr006]

​@@asdfaam it's a big leap for the ops teams to transition from fee-for-service to capitation and difficult to manage both models simultaneously. Totally agree that capitation makes the most sense for providers and assists with resolving some of the cashflow challenges.