RCM — Revenue Cycle Management

What Is RCM?

RCM (Revenue Cycle Management) is the end-to-end process of managing the financial lifecycle of a patient encounter — from scheduling and registration through charge capture, claims submission, payment posting, and denial management.

In healthcare, the revenue cycle is particularly complex. Each encounter generates multiple transactions involving the patient, the healthcare institution, insurance companies, and government programs. Major companies like Oracle, SAP, and Epic have developed dedicated RCM modules to address this complexity. An inefficient RCM results in revenue leakage, avoidable denials, and deteriorated cash flow.

In Latin America, RCM has unique characteristics: multi-payer management (insurance companies, government programs, and self-pay patients), differentiated fee schedules per contract, mandatory electronic billing in several countries, and pricing regulations that vary by jurisdiction. These particularities demand solutions adapted to the regional context, not simply translations of systems designed for the North American market.

Why It Matters in Healthcare

• Financial sustainability: an efficient RCM can increase a hospital's net revenue by 3% to 5% by reducing leakage and denials.
• Multi-payer management: in Latin America, institutions simultaneously handle multiple payment sources with different rules and fee schedules.
• Denial reduction: correct capture of clinical and administrative data from registration minimizes insurance rejections.
• Financial visibility: RCM dashboards identify bottlenecks and improvement opportunities in real time.
• Patient experience: transparent and efficient billing processes improve satisfaction and reduce complaints.

How Davix Relates to RCM

• The Davix Gestión Comercial module covers the full revenue cycle: from admission to collections, with multi-payer and multi-site pricing rules.
• Native support for electronic billing according to each Latin American country's regulatory requirements.
• Direct integration with the Davix HIS, ensuring that clinical data required for billing is automatically captured during care delivery.
• Business Intelligence dashboards providing real-time visibility into revenue cycle performance.
• Contract-based fee schedule management with configurable business rules for each payer.

Optimize your healthcare institution's revenue cycle. Explore Davix Gestión Comercial and transform the financial sustainability of your network.