Revenue Cycle Management and Bundled Payments in India

Revenue is the most important element for the survival of any entity. Therefore, Revenue Cycle Management (RCM) is a growing concept and industry by itself. The economic sector that uses this concept the most is the health care sector. With the involvement of huge volumes of insurance claims to be redeemed by health care units, RCM becomes all the more important for them. The probability for disallowance by insurance providers is always on the higher side. The revenue is generally blocked in the form of receivables, which are highly prone to disallowances, and affects the revenue cycle management massively. This research paper while taking into consideration these insurance claims and probability of insurance disallowance, will be trying to formulate a ratio that describes the tolerable level of rejections that a unit can suffer at different levels of revenue. The other area focused under the study would be the viability of Bundled Payment System in India. The bundle payment system is where the patient is asked to make payment of a certain amount, upfront for all the episodes of care. The major concern for the acceptance of such a system in India would be the psychological factors amongst Indians.