Are you stressed about keeping track of your money? Don’t you want an easy way to pay? If yes, then you are at the right place! Revenue Cycle Management (RCM) software is a great way for companies to make their financial operations run more smoothly. With automatic jobs like payment handling, billing, tracking records, and collections, it can make bills work better.
Creating revenue cycle management software helps companies learn more about their customers, make payments faster, and make them happier. Businesses spend money on developing RCM software to make sure that deals go smoothly and to build a steady stream of income. This blog will tell you how to develop a software for RCM that will give you all the information you need.
What is RCM Software?
A crucial procedure in the healthcare sector addressing the financial elements of patient treatment is revenue cycle management software. From appointment planning to billing and payment collection, RCM covers the lifetime of a patient’s contacts with a healthcare practitioner. Maximizing income collection and lowering the time and effort invested in administrative chores are RCM’s main objectives.
By automating numerous repetitive operations involved in medical billing and revenue management like processing payments, collecting charges, confirming insurance eligibility, healthcare revenue cycle management software simplifies these processes. It also helps medical professionals find and fix any disparities or mistakes that can cause rejections or delayed billing. Reduced accounts receivable days, more cash flows, and higher patient satisfaction may all follow from effective RCM systems.
Market Statistics of Revenue Cycle Management Software
The RCM software market size has grown rapidly in recent years. Here is the latest market overview for this industry.
- The global RCM software solutions market size was valued at $135.92 billion in 2023 and is expected to reach $148.84 billion by the end of 2024 as per a research done by Fortune Business Insights.
- The RCM softwares is projected to grow up to $361.86 billion by the end of 2032, exhibiting a CAGR of 11.7% during the forecast period (2024-2032).
- Another research shows that it will grow from $51.04 billion in 2023 to around $56.64 billion by the end of 2024. This research was conducted by TBRC Business Research.
- The growth will take place with a compound rate of 11%.
- Reasons for the expansion within that time frame include rising healthcare expenditure, more demand for healthcare services, more use of cloud-based solutions, and industry consolidation.
Key Features of Medical Revenue Cycle Management Software
Custom Revenue Cycle Management software development calls for careful consideration of numerous key features that could raise income, simplify billing process, and increase efficiency. The following are some essential components for your own RCM solution:
1. Data Security and Compliance
In the healthcare sector, especially with regard to handling private patient data and guaranteeing respect to laws like the Health Insurance Portability and Accountability Act (HIPAA), data security and compliance are absolutely vital. Strong security features of custom RCM software systems should guard data and follow pertinent laws.
2. Customization Options
Every healthcare professional has different needs, hence a one-size-fits-all solution could not be enough. By modifying billing rules and workflows to fit internal processes and payer criteria, customizable healthcare RCM software systems let healthcare companies customize the system to their own needs. This adaptability can help to reduce income loss from non-compliance and billing mistakes by means of improved efficiency.
3. Integration with EHR and Other Healthcare Systems
By lowering manual data entry and guaranteeing data consistency across the company, seamless integration between RCM billing software and current healthcare systems, including Electronic Health Records (EHR) and EHR software development, can greatly increase your productivity. By means of a consolidated view of patient data, this integration enables healthcare practitioners to gain from administrative work simplification and improved delivery of treatment.
4. Real-Time Analytics and Reporting
Real-time reporting and analytics tools give medical professionals an understanding of their financial situation and point out areas needing work. These instruments can monitor important performance metrics, including charge capture rates, days in AR, and denial rates. By leveraging reporting software development, RCM custom software development companies can enable clients to monitor their revenue cycle and make data-driven decisions to maximize financial operations.
5. Denial Management
Payers may underpay, reject, or deny claims for a variety of reasons, including eligibility problems, insufficient data, or erroneous coding. Good denial management is realizing the causes of denials, fixing, and resubmitting the claims, and putting policies in place to stop more denials.
6. Payment Posting
Payment posting is precisely entering and matching incoming payments from payers or patients into their corresponding accounts. For patients as well as providers, effective payment posting systems help to reduce mistakes, stop duplicate or missed payments, and increase financial openness.
7. Claims Submission
Following classifying the rendered medical services, the healthcare provider files claims to the relevant payer, such as insurance companies, government programs like Medicare, or patients personally. Accurate and timely claim submission can help to improve income generating and cash flow through EHR software development.
8. Charge Capture
Recording the services rendered to the patient, charge capture uses those records to create a bill. Maximizing income, avoiding billing mistakes, and guaranteeing payer compliance depend on accurate and fast charge recording.
9. Insurance Verification
One should confirm a patient’s insurance eligibility, coverage, and benefits before offering healthcare services. This procedure guarantees that the entered claims are valid and include the required data, therefore reducing the possibility of rejection and delayed refunds.
10. Patient Registration
Registration of the patient, gathering their personal and demographic data, and verifying their insurance coverage constitute the initial stage of the RCM software development ideas. Accurate data entering is essential since mistakes in this stage could cause delayed payments and denials of claims.
Top RCM Software Solutions
Below we have shared some of the best RCM software systems available in the market.
1. Epic RCM
Designed to easily interact with current systems of healthcare revenue cycle management software, Epic Systems is a complete solution. It automates payment collecting, claims processing, and billing using cutting-edge technologies. Offering several revenue cycle management solutions, it is among the top EHR providers. Many elements define the epic revenue cycle management, including:
- Patient automated billing system
- Follow-up and claims handling
- Charges capture and coding.
2. Cerner Millennium
One strong platform meant to simplify financial operations in healthcare is the Cerner automation tool. It is meant to guarantee accurate and exact revenue cycle management and assist practices in negotiating the complexities of healthcare finance. Cerner is another electronic health record management software. It can also interact with services in the healthcare revenue cycle management software market. It involves:
- Real-time checking of insured claim
- Process of automated billing and invoicing
- offers the patient tools for self-service.
3. McKesson
A powerful rcm software aiming at maximizing financial operations for healthcare providers is McKesson. It automates chores such as billing, claims processing, and payment collecting and fits quite nicely with existing systems.
- Integrated payment operations handle
- Automated functioning of automatic claim submission
- Track record of patients in real-time
4. Athenahealth
This medical revenue cycle management software guarantees a modern platform meant to improve the financial operations of healthcare providers. Athenahealth lowers denials and helps find income prospects with its real-time analytics and insights.
- Adaptable payment and deployment choices
- Offer self-service facilities for patient payment of the bill.
- Combined offerings to submit timely claims
5. Kareo
Designed to fit independent healthcare practitioners and small offices, Kareo is a creative rcm software healthcare tool. Strong support and training tools provided by this RCM automation platform help to guarantee that practices may optimize their advantages and concentrate more on providing superior patient treatment.
- Procedures of patient billing and collecting.
- Insurance claims are turned in fast.
- Offers the EHR for better improvement.
Also read: Medical Billing Software Development Cost and Key Features
Cost to Develop Revenue Cycle Management Software
The main things that determine how much it costs to make RCM software are its complexity, functions, features, and size of the app. The software development cost also relies on the number of developers you are hiring for your project. So, it costs between $10,000 and $100,000 to develop an app for revenue cycle management.
RCM Software Type | Estimated Cost | Time Frame |
Simple RCM Software | $10,000 to $30,000 | 3-6 months |
Medium-Complex RCM Software | $30,000 to $50,000 | 6-9 months |
Highly-Complex RCM Software | $50,000 to $100,000 | 12+ months |
Keeping the revenue cycle management software up to date costs about 15% to 20% of the total cost of making it. This includes solving bugs or other problems that happen naturally when the software is used. Keep checking your software for security leaks, malware, and other threats on a daily basis.
Tech Stack Required for RCM Software Development
When creating revenue cycle management software, using the right technology stack plays a vital role. Hire a bespoke software development firm to assist you in integrating the most suitable technology stack into your product, allowing you to build versatile and dependable software that works across all platforms. You can check out the table shared below to know the top tech stack that should be used in making the RCM software.
Layer | Technology | Focus |
Frontend | CSS3, HTML, & Reactjs | Overview of the frontend |
Backend | Nodejs, Python, & Java | Data distributions & security restrictions |
Database | PostgreSQL & Microsoft SQL Server | Store large amount of data easily and securely |
Version Control | Git | Version tracking and collaboration |
Testing | Security testing, Integration testing, & Unit testing | Ensure code functionality and integrated features are working fine |
deployment | GCP, AWS, & Microsoft Azure | Efficiently deploy in any of the platforms |
Steps for the RCM Software Development Process
When it comes to online billing and the many payment methods it offers, rcm medical billing software is well-known in this virtual realm. Accordingly, a software development company like Octal IT Solutions specialized in revenue cycle management provides a number of software development consulting services to ensure the product’s smooth development. The steps are as follows:
1. Define Target Audience and Requirement
Step one is to zero in on your prospective clients by studying your target market’s unique requirements. Learn the ins and outs of current RCM software so you can build effective software that stands out from the crowd. Verifies that your software complies with industry-specific security standards.
2. Designing and Architecture
Recruiting specialized developers to create an intuitive and one-of-a-kind user interface is the second stage. To make sure your software runs properly, use the right programming languages, databases, and frameworks. With its intuitive design, simple navigation, and well-labeled features, it aims to attract more users.
3. Coding and Development
In the third stage, the EHR software development team writes code that implements the design and architecture. Here, we lay the groundwork for future enhancements by adding premium or rich features and functionalities on top of the fundamental core capabilities. Talk to a software development company if you need help putting together a crack team of programmers for your next project.
4. Testing and Quality Assurance
Now, we may go on to the testing phase, which encompasses several types of software testing services, such as user acceptability, white-box, integration, and unit testing. By the end of this stage, you should have software that runs smoothly with no hiccups whatsoever. The security measures for the user’s sensitive information are also tested.
5. Deployment and Launching
Here is where your software requirements and personal preferences for companies concerned with data security metrics should inform your choice of deployment technique. In order to deploy the RCM software effectively on numerous platforms like IOS and Android, it is necessary to engage software developers. Next, you’ll need to devise a plan to break into your target market and start raking in the dough.
6. Maintenance and Updates
It entails monitoring customer input on a frequent basis, upgrading features that are out of date, and addressing problems and malfunctions after publication. Additionally, it finds fresh openings for the most recent feature enhancements. Make sure your software is up-to-date with the newest needs of target consumers and stay informed on modifications according to industry guidelines.
7. Futureproofing
As a final development phase, think about where you want your RCM software to go in the future and make sure it accounts for current market trends. Also, read the feedback people have left for your program, think of new features to add, and stay up-to-date with the latest trends. Keep up with new innovations so you can add features that will set your program apart from the competition.
Key Takeaways From RCM Software Development Process
This blog post discussed how to make revenue cycle management software and why businesses should use it. RCM healthcare software simplifies tasks like bills and sending receipts. It also cuts down on mistakes and gives useful data insights. It shows you how to improve your cash flow, work more efficiently, and handle financial changes in a safe and correct way. The RCM software development can help your business grow in this field and reach new heights of success.
Get in touch with Octal right away if you want to take advantage of cutting edge RCM solutions and a clinic management system that works well. Octal provides a wide range of RCM services through AdvancedMD, and our customers don’t have to pay extra for these services. We’ve been in business for almost 20 years and just finished more than 1,500 projects for more than 700 happy customers. Our team of more than 250 professional developers is the best at what they do and builds RCM software in the best way possible.
Also read: POS Software Development – Cost and Key Features
Common FAQs Before Hiring a RCM Software Development Company
What are the key stages of the RCM software development process?
The RCM development process includes discovery, design, coding, testing, deployment, and ongoing support. We start by gathering requirements and then design and develop the system. After rigorous testing, we deploy and integrate it with existing systems, followed by continuous maintenance, updates, and customer support.
How will the RCM software integrate with our existing systems?
We integrate RCM software with EHR, ERP, and other systems using secure APIs and data mapping. Our approach ensures seamless data transfer and real-time updates between systems, reducing disruptions. The solution is designed for future scalability, enabling integration with additional systems as your needs evolve.
How do you ensure data security and privacy throughout the development process?
We implement secure coding practices, data encryption (in transit and at rest), and role-based access control. Our software is built to meet HIPAA and GDPR compliance standards. Regular security audits and penetration testing are conducted to ensure data privacy and minimize vulnerabilities throughout the development process.
How do you handle system updates, upgrades, and scalability as the business grows?
Our RCM solutions are designed for scalability, allowing easy updates and upgrades as your needs evolve. We build flexible architectures that can handle increased data volumes. Regular software updates, feature enhancements, and security patches ensure the system grows with your business and regulatory changes.
What kind of support and training do you offer after the software is deployed?
Post-deployment, we provide comprehensive training, including user manuals, videos, and hands-on sessions. Our ongoing support includes troubleshooting, updates, and security patches. We ensure your team is fully equipped to use the software effectively, with prompt assistance available through multiple channels to resolve any issues.