In the United States, the Revenue Cycle Management (RCM) process begins the moment a patient schedules an appointment with a healthcare provider and continues until the provider receives full payment for the services rendered. It is a crucial financial process that ensures healthcare organizations are reimbursed accurately and efficiently for the care they provide.

When a patient visits a doctor, the revenue cycle starts with insurance verification and patient registration, followed by medical coding and claims submission to the insurance payer. The claim then goes through adjudication, where insurers review and either approve, deny, or request additional information. If a claim is denied or underpaid, denial management and appeals come into play to recover lost revenue. Once payments are received, payment posting and reconciliation ensure accurate financial reporting.