Revenue cycle management

Revenue cycle management (RCM) is the process used by healthcare systems in the United States and other countries to track the revenue from patients, from their initial appointment or encounter with the healthcare system to final payment of a balance. It is a normal part of health administration in some countries. The revenue cycle can be defined as, "all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue." ^[1]

Overview

The revenue cycle begins when a patient schedules an appointment and it ends when the healthcare provider has accepted all payments. Errors in revenue cycle management can lead to the healthcare provider receiving delayed payments or no payment at all. Because the revenue cycle process is complex and subject to regulatory oversight, healthcare providers may chose to turn over their revenue cycle management to companies that handle this process with specialized agents and proprietary technologies.^{[ citation needed ]}

Proper revenue cycle management is intended to ensure that billing errors are reduced so that reimbursements from the insurance companies are maximized. Revenue cycle management teams are responsible for maintaining compliance with coding regulations, such as the ICD-10 code update in the United States. Using the right coding for services rendered by a practice is intended to ensure that insurance claims can be processed and that the practitioner is compensated for all of their services rendered.^{[ citation needed ]}

In 2024, the global revenue cycle management market was estimated at $344 billion. ^[2]

Revenue cycle management is often considered a segment of the greater healthcare IT industry which includes HIS, RIS, EHR, PACS, CPOE, VNA, mHealth, healthcare analytics, telehealth, supply chain management, CRM, fraud management, and claims management. ^[3]

References

1. "Healthcare Financial Management Association, Online Glossary".
2. "Revenue Cycle Management Market Share Report, 2025 - 2033". Grand View Research. Retrieved October 15, 2025.
3. "Common Revenue Cycle Management Pitfalls to Avoid". 31 August 2015.