Revenue cycle management is a chain of hand-offs. When people understand only their own link, errors are passed downstream and nobody can explain why cash is late. RCM Fundamentals gives you the whole chain in two weeks: who does what, which documents and codes move between steps, where claims fail, and how money is finally posted. You leave able to read a claim, an EOB and an AR report, and to describe what a good process looks like at each step.
Who this course is for
Anyone entering healthcare revenue cycle work: new hires at practices and billing companies, front desk staff who want to understand what happens after check-in, and career changers deciding which RCM role suits them.
What you will be able to do
- Explain every step of the revenue cycle and who owns it
- Read a CMS-1500, an ERA and an AR aging report
- Identify where a claim failed from its status and remittance codes
- Decide which RCM specialization to pursue next
Course content
1Week 1: From appointment to claim
- Roles in the revenue cycle and how they hand off
- Scheduling, registration and demographic accuracy
- Insurance basics: plans, networks, eligibility, benefits, authorizations and referrals
- The encounter: documentation, superbills and charge capture
- Codes that travel with a claim: ICD-10-CM, CPT, HCPCS, modifiers, place of service
- Anatomy of the CMS-1500 and the 837 electronic claim
2Week 2: From claim to cash
- Clearinghouses, scrubbing, acceptance and rejections
- Payer adjudication and the remittance (ERA/EOB)
- Payment posting, contractual adjustments and patient responsibility
- Denials versus rejections, and the follow-up process
- AR aging, timely filing and write-offs
- Key performance indicators a practice should watch
Practical component
Trace three synthetic patients from appointment to payment in the Revelrex training EHR: build the claim, read the remittance, post the payment and explain the balance.
Assessment
Two short quizzes and a final exercise (trace-the-claim). Pass mark 70%.
Completion
Attend or watch all six sessions, complete the quizzes and pass the final exercise.
Check your email for the next steps.