Revenue cycle management: Avoiding the most common RCM mistakes

Effective revenue cycle management is essential for the financial health of any medical practice. At its core, RCM encompasses the entire financial process of a patient encounter—from appointment scheduling and insurance verification to claims submission, payment collection, and denial management. When executed efficiently, it ensures that a practice is reimbursed accurately and promptly for the services it provides.

For independent physicians and small practices, strong RCM processes are particularly crucial. Unlike large hospital systems with dedicated billing departments, smaller practices often operate with lean administrative teams. Errors in coding, delayed claim submissions, or ineffective patient collections can result in significant revenue losses, impacting a practice’s ability to invest in staff, technology, and patient care.

The complexity of medical billing has only increased in recent years due to evolving insurance policies, regulatory requirements, and patient cost-sharing trends. High-deductible health plans mean that more financial responsibility falls on patients, making it imperative for practices to implement clear communication and efficient collection strategies. Additionally, payer rules frequently change, requiring ongoing staff training and vigilance to prevent claim denials.

Technology plays a growing role in RCM, with automated billing systems, analytics tools, and artificial intelligence helping practices streamline workflows and reduce errors. However, even with the best technology, human oversight and strategy remain vital. Physicians who own their practices must understand common RCM pitfalls and implement best practices to optimize cash flow and reduce administrative burdens.

Medical Economics spoke with Stacey Bartell, MD, medical director for career and practice, with the American Academy of Family Physicians, to learn more. In this episode, Bartell discusses common mistakes in RCM.