How to Successfully Maximize Healthcare Reimbursement and Improve Revenue Cycle

Revenue Cycle Management (RCM) is a top priority for all healthcare organizations. Balancing collection on difficult claims, keeping cash flowing for your organization, all while staying focused on delivering quality patient care can be difficult. Therefore, it’s important for every healthcare organization to have a process and billing team in place to continuously maximize reimbursement and improve revenue cycle management. Implementing and successfully running your RCM can be a challenging and involved process, so let’s take a look at what important factors contribute to maximizing your RCM. 

Financial Data Review 

Processes should be in place to review all facility data and verify patient information to ensure you are getting the most money for the services provided to their community. This ensures that all claims have been processed correctly and mediate for claims that process out of order from previous billings. 

Streamline Reimbursement

Delay or denial of claims can adversely affect the revenue cycle of a healthcare organization. You should have a billing process in place that ensures your claims will pass through the fiscal intermediary correctly the first time, ensuring you accurate and faster payments. It is essential to follow up on claims that may be sitting in an unpaid status to process them through the system faster. While streamlining reimbursement may be a timely process for a billing team, it is just as important to have a billing process that implements: 

  1. Providing reliable and accurate information
  2. Having knowledge of and meeting billing requirements for each individual payor
  3. Submitting claims within the prescribed time frame allowed
  4. Having a expert and experiences team at hand to reduce admin burden


RCM and medical billing includes protected health information, so understanding the importance of keeping records confidential is critical to your RCM. On top of that, a healthcare organizations process for collecting information from facilities and for submitting claims should be done with regard to following HIPAA standards, ensuring PHI and records stay confidential. 

Strong Billing and RCM Team 

At the core of maximizing your RCM is having an experienced and expert billing team manage your RCM. Your billing team should have a proactive strategy utilizing a combination of monitoring and prioritizing workload including stringent monitoring of timely filing and timely billing timelines. Just as important is keeping your billing team updated and trained on rcm rules is essential to financial success. 

Experience the Primavera Difference

Implement and successfully run your RCM to maximize reimbursement with Primavera Billing and RCM Services. The Primavera Approach leverages technology and deep experience in billing and coding to help your operation reach peak performance with your practice’s RCM. Providing revenue optimization and improved medical economics by reviewing all financial data, streamlining reimbursement, providing confidentiality and providing a strong billing team.  

Discover how Primavera’s leading billing and RCM services can transform your RCM. When you choose Primavera Health Billing and Revenue Cycle Management Services, you choose a team that holds extensive experience in medical billing and revenue cycle management services as well as:  

  • Extensive EMR and billing systems experience
  • Consultants are certified with multiple platforms
  • Deep experience with all Medicare, Medicaid, and commercial payers nationally
  • A technology approach, to simply data and an organization’s process to improve patient outcomes and overall practice performance 
  • A team that works alongside you to develop rules and assist with implementing new and improved RCM processes

Reach out to us today to learn how we support you to continually improve your RCM across your organization. Fill out the form below to schedule your Free Consultation with our team! 

(888) 667-2219

[email protected]

Rolian RuizHow to Successfully Maximize Healthcare Reimbursement and Improve Revenue Cycle