Revenue Cycle Technology (RCT) is the use of systems,
processes, people & technology to generate revenue for healthcare services
Before RCT the industry was referred to as 'Revenue Cycle
Management (RCM) due to the dependency on a small group of people with
expertise in the industry.
With the general availability of information technologies
such as -
the dependency on people has greatly reduced, making new, scalable solutions available for healthcare providers at highly affordable prices.
The organization responsible for coining the term
'Revenue Cycle Technology' and showcasing its capabilities is AuroraRCM.
AuroraRCM was founded by industry veterans who realized the need for Technology in Healthcare Revenue Cycle. The
company was named after the Latin mythical goddess of dawn - Aurora who
symbolizes Dawn, Light and New possibilities.
The need for a technology-enabled healthcare revenue
cycle solution has been prevalent for decades. Traditional Revenue cycle
companies charge healthcare providers a percentage of collections while RCT
companies are able to provide superior services, consistent quality and
automated solutions for a fraction of that cost. At the birth of any industry,
middlemen are required to bridge the gap between two key players. This gap has
been made short by the introduction of Revenue Cycle Technology giving
healthcare providers a better share of their revenue.
Revenue Cycle Technologies so far has taken the form of
three categories targeting the needs of healthcare providers.
Business intelligence is a key requirement in any
industry. However, in Healthcare, it plays a pivotal role in identifying
opportunities and helping allocate resources. Example: A physician would not
know the potential revenue opportunity of not participating in an insurance
network. A common misunderstanding in insurance network participation is that
the provider can choose to charge a higher amount that he/she believes is
reasonable. But the amount of patient responsibility and re-circulation of a
claim between the insurance and the patient can be far more costly.
Meaningful business intelligence helps providers make the
right decisions by showing the factual implications of a practice.
There are two types of software systems used in the
healthcare space -
There is no other industry where 'legacy', 'on premise'
systems are more prevalent than in the Healthcare industry. Due to the large
investments that have gone into these systems, the decision to change can be
painful. Due to the lack of integration between Patient Care Systems and
Billing Systems, a lot of manual labor is used to transfer data from one system
to another. With RCT, this step is no longer necessary. RCT is able to directly
integrate two systems so that they work as one and duplicate labor is
eliminated, saving valuable time and resources.
The process of converting a medical service into a
payable claim involves multiple steps from gathering the correct information,
insurance verification, service authorization, medical documentation to coding.
In case of a claim rejection or denial, the process re-starts.
Revenue Cycle Technology is able to understand all
possible outcomes and be programmed to take the right action based on any claim
situation. This eliminates the need to be dependent on few highly experienced
professionals and because the solution uses a computer, the possibilities of
human error are removed from the equation, ensuring 100% compliance 100% of the
The introduction of RCT to healthcare marks a remarkable
milestone in the technological capabilities of mankind. Technology has always
elevated human capabilities and enabled us as a species to move from one level
of effectiveness to a higher level of effectiveness. Computer algorithms have
enabled us to move from performing 'repetitive tasks' to 'prescribing