Value Cycle Mangement-Moving Beyond Fee-For-Service

Gold Standard Billing Underpins Your Earnings

The phrase revenue cycle management is often used interchangeably with medical billing. Many have a vague idea of what it actually means. Gold Standard Revenue Cycle Management is backed by years of research by the Medical Group Management Association that defines criteria and metrics that together result in best performance of payment collections and patient satisfaction. The Revenu Cycle begins at the point of the first call for an appointment by a patient. The insurance they have, and the benefit package of their coverage set the stage for the payment gauntles. Every service follows a defined pathway until final collection of all payments due from each responsible party. As payer rules change, patient status modifies including marital status, employment, changing insurance benefits and family dependents the job of getting paid for medical care delivered is in constantflux. Revenue cycle mangement organizes the monitoring and tracking of details. The key thing to know about revenue cycle management is the payers are in control. Save a life by diagnosing a patient in extremis at their office visit and you may get paid the same as seeing them for a bronchial infection. Value is not really incorporated into the reimbursement process outside of your knowledge as reflected by “complexity” and a rough approximation of time spent with the patient.

Understand Your Market

Value Cycle Management builds on the foundation of Gold Standard Revenue Cycle Management but moves beyond payer control to reasserting your own control over your business and financial destiny. Value Cycle Management assumes a rigorous implementation of the business revenue cycle information process to maximize complete and timely payment for services but incorporates three additional important elements.

  • Market understanding of your patient panel so that you can identify services that go beyond fix-it-when-it-hurts to products and services that engage patients in managing their health.
  • Product pricing for services offered to age and gender cohorts that are valued by patients for which they will pay a subscription fee.
  • Specialization of tasks within a service team that enables you as the physician to guide overall direction and quality of services. The platform enables you to reach out beyond the walls of the clinic to engage patients in ways that will enhance outcomes and garner improved overall outcomes. An example from primary care is the tracking and coordination of care for a patient post discharge from the hospital. While proven to make a significant difference in the speed of recovery and avoidance of re-admittance, many primary care doctors are not even notified when their patient is discharged, let alone have time to coordinate care for them, for which they will be reimbursed modestly, if at all.

New Services and Income Streams Returns Control of Your Practice To You

Value Cycle Management then is the practice business management process that initiates products and services on behalf of patients, responsive to the market of patient needs with recognized value for which patients and their families will pay. The added income and quality of patient exchange adds value for physician as well. You gain economic control. For the first time the revenue from third party payers is only one of several sources of payment. Your additional service menu will generate from 40% to 60% of the total revenue of the practice.

Value Cycle Management extends this economic concept to a more profound level, so you regain control of patient satisfaction and your own professional and personal return from your practice.

In short, Value Cycle Management puts you in control. The MDCommerce Value Cycle Management platform is the combined business model, product ideas, information systems and tools, staff and processes that enable you to move to control as we assists you in building a more rewarding practice. Getting there is a process with immediate pay offs in increased revenue as you move to the highest level of Gold Standard RCM. But as you do this you begin the work of assessing your practice, defining the value generating enhanced services you will offer and plan your first step into a rewarding future delivering care with satisfying results and greater take home income. To Get started with a free initial Value Cycle Management Opportunity Assessment call us at or

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Get Started with Value Cycle Management