Everything You Need to Know About an RCM Software

Efficient Revenue Cycle Management is the key to success for every business, and eye care practices are no exception. Poor RCM processes can mean lost revenue, which is the last thing any eye care practice wants. But what is RCM?

RCM includes all admin and clinical functions that contribute to capturing, managing, and collecting patient service revenue – from claims submission and payment processing to insurance collections. RCM also involves following up with payers when claims are denied. Simply put, RCM is your eye care practice’s billing process, and without an efficient billing process, it may become challenging to maintain a practice’s financial viability and provide quality care.

Why is RCM important?

The increased focus on holistic patient care and the move toward value-based reimbursement is forcing eye care providers to take a closer look at the way they approach RCM.

Faulty billing practices often result in financial losses and put the provider’s ability to deliver quality care at risk. Streamlining and improving core operational processes can help eye care providers remain financially viable. With this in mind, eye care providers search for solutions to save them time and money and turn to revenue cycle management software.

What is RCM Software?

When it comes to building a healthier bottom line, the bad news is that the current healthcare payment system is not provider friendly. The complexities of insurance and the way services are billed and collected are counterproductive to providers’ ability to get paid quickly. However, the good news is that there are ways to ensure getting paid the full amount from providers and patients and thereby reduce revenue loss. With the right tools and software to handle your billing, you can track what’s going out and what’s coming into your practice.

Revenue cycle management software (RCM software) improves the financial stability of your eye care practice by automating administrative tasks and streamlining the business side of your practice by getting more money per patient, quickly, and with lesser efforts.

How RCM Software helps Eye Care Providers Improve Cash Flow?

Here are some of the features of RCM software that reveal how central and efficient this system is for eye care providers:

  • Pre-visit authorization

It is a good practice to check insurance eligibility before the patient comes in for the appointment. Pre-visit authorization involves confirmation by the insurer that a medical procedure or prescription is required. Using the RCM software, your staff can check on patient insurance status and get the ball rolling and set up the time and date for a visit. When done correctly, this step can help reduce claim denials.

  • During the Visit

As you check each patient, you can use the RCM software for collecting copays. It is better to bring in this revenue than wait for payments to be settled after the patient receives repetitive bills. This will save on staff time and burden since they will not send multiple copies of the bills.

  • Post-Visit Payment Processing 

RCM Software allows you to enter payment information after the patient visit. With accurate data in place, you can monitor the revenue at the end of each week or month.

  • Reducing Claims Denials

One of your goals is to bring down the number of rejected claims. Since many rejections occur because of human mistakes during the data entry stage, the use of RCM software will reduce the number of denied claims.

  • Tracking Pending Claims

Claims that have not been denied but are pending must be tracked. Using the RCM software, you can stay on top of this anticipated revenue, giving your team the financial information, it needs to plan marketing campaigns or staff requirements.


Eye care practices that embrace RCM software can rest assure that they are doing what’s needed to grow, remain competitive, and ensure a healthier bottom line. The time you save and the extra revenue you can expect to see after implementing a revenue cycle management software will give you more resources to deliver quality care to patients.

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