Global Revenue Cycle Management Market has accounted to about USD 29.5 billion in 2018, rapidly growing at a CAGR of 12.5% from 2019 to 2026, is expected to reach USD 75.69 billion by 2026. The new market report contains data for historic years 2015, the base year of calculation is 2018 and the forecast period is 2019 to 2026.
RCM combines management data, such as patient names, insurers and other personal information, with treatment and health care data that patients receive, integrating the business and clinical aspects of healthcare. Communicating with a health insurance company is a key element of RCM. When a patient makes an appointment, the doctor’s office or hospital staff usually checks the patient’s reported insurance coverage before the visit. After the insured receives treatment for a given condition and provides the corresponding copayment, the provider or coder classifies the nature of the treatment according to the ICD-10 code. The hospital or treatment facility then sends the treatment summary along with the ICD and Current Procedural Technology codes to the patient’s insurance company to cover some of the insurance billed for the rest of the patient.
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Key players Profiled in this Report are: All scripts Healthcare Solutions, Inc. (IN), athenahealth, Inc. (US), CareCloud Corporation (US), Cerner Corporation (US), Conifer Health Solutions LLC (US), eClinicalWorks (US), Epic Systems Corporation (US), Experian Information Solutions, Inc.(US), General Electric Company (US), GeBBS Healthcare Solutions (IN), McKesson Corporation (US), NXGN Management, LLC. (US), nThrive, Inc. (US), Quest Diagnostics Incorporated (US), SSI Group, LLC (US)
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Revenue cycle management (RCM) is applied by healthcare organizations to scale and manage the process of healthcare billing and reimbursements. It is done by improving the process of claims management, accelerating explanation of benefits (EOB) reconciliation, improving the quality of information, streamlining denial management, and by automating processes. The RCM solution manages the patient’s bills from entering the hospital to reimbursement of claims.
- Factors like decrease in reimbursement in healthcare industry, reduction of total healthcare costs, initiatives undertaken by governments for implementation of revenue cycle management solutions, and increasing expenditure by healthcare industry especially made on IT are the major drivers of the global revenue cycle management market.
- Key advantage over traditional revenue cycle management.
- Lack of training and skills in the staff.
- Lack of technical infrastructure support
Segmentation: Global Revenue Cycle Management Market
- By Product Type
- Integrated RCM
- Standalone RCM
- By Stage
- Front Office
- Mid Office
- Back Office
- By Function
- Claim & Denial
- Medical Billing Coding
- Payment remittance
- Electronic health record
- Clinical documentation improvement
- Insurance Verification
- Others (scheduling & appointment, referral management, and contract management)
- By End-User
- General Physicians
- Other end users (pharmacies, emergency medical centers etc.)
- By Deployment
- By Component
- By Geography
- North America
- South America
- Rest of South America
- United Kingdom
- Rest of Europe
- South Korea
- Rest of Asia Pacific
- Middle East & Africa
- South Africa
- Saudi Arabia
- United Arab Emirates
- Rest of Middle East & Africa
- North America
Key Developments in the Market:
- In June, Quest Diagnostics, the world’s leading provider of diagnostic information services, unveiled the newest version of its Quanum Enterprise Content Management Solution. This solution will expand the company profile and portfolio.
- In October, eClinicalWorks, a market leader in ambulatory clinical systems, announced eClinical Works Revenue Cycle Management (RCM) to aid medical practices in optimizing billing. This solution launch will expand the company growth rate and portfolio.
Competitive Analysis: Global Revenue Cycle Management Market
Global revenue cycle management market is highly fragmented and the major players have used various strategies such as new product launches, expansions, agreements, joint ventures, partnerships, acquisitions, and others to increase their footprints in this market. The report includes market shares of revenue cycle management market for global, Europe, North America, Asia-Pacific, South America and Middle East & Africa.