Revenue Cycle Management
Revenue cycle management (RCM) is the operational discipline that tracks patient care from registration through final payment — eligibility, coding, claims, denials, collections, and posting. In HealthOS, RCM is the Financial Intelligence layer; it is not a separately procured product. The revenue cycle and the clinical cycle operate on one record.
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Standalone RCM products produce a parallel set of books. Charges enter days after the clinical event. Eligibility checks are batch jobs. Denial management is a back-office tower disconnected from the front-of-house clinical work that generated the issue.
How HealthOS runs it
The institutional workflow.
- 01
Eligibility is verified at the moment of booking, against the institutional payer-rules engine.
- 02
Coding occurs at the moment of clinical event documentation, surfaced inline to the clinician for review.
- 03
Claims submit automatically on event completion; denials surface to the institutional role responsible.
- 04
Collections, posting, and reconciliation are continuous against the same record.
- 05
The Financial Intelligence dashboard reports cycle performance — days in AR, denial rate, contracted variance — same-day, against the live record.
Canonical layer
This workflow runs on the Financial Intelligence.
The Financial Intelligence is one of the layers of HealthOS. It is not a separate product; it is a property of the substrate. See the Financial Intelligence layer →
Defined terminology on this page
Frequently asked
Can HealthOS replace our existing RCM vendor?
Yes. The Financial Intelligence layer is architectural replacement, not integration. RCM-vendor migration is part of the Coherence Model Stage III adoption phase.
How is contracted-rate variance handled?
Contracted rates per payer are loaded into the Financial Intelligence layer; variance against contracted rates is computed per encounter and surfaced same-day.
Revenue cycle is not a separate product. It is the financial expression of the clinical cycle. They run on one record. Signed by the Veronara Financial Intelligence Office.
Dated · Propose a correction to corrections@veronara.com.
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