The Revenue Cycle Management Certificate Program is designed with ROI in mind. The program provides the knowledge and skills required to develop, manage, and improve the revenue cycle for healthcare organizations. It also helps participants understand and comply with federal and state regulations governing revenue cycle management. Finally, it prepares participants to take the Certified Revenue Cycle Professional (CRCP) exam offered by the Healthcare Financial Management Association (HFMA).

The modules in the program provide a comprehensive overview of the revenue cycle. Each module explores the revenue cycle from a unique perspective and provides a framework for identifying inefficiencies and opportunities for improvement. The program also covers federal and state regulations governing revenue cycle management. Finally, it prepares participants to take the Certified Revenue Cycle Professional (CRCP) exam offered by the Healthcare Financial Management Association (HFMA).

What Is Meant By “Certified Revenue Cycle Professional”?

While it is a fairly common certification, there are a lot of people who don’t know about Certified Revenue Cycle Professionals. The certified revenue cycle professional is responsible for all aspects of revenue cycle management within a healthcare organization. They work in a mid-management position and are responsible for developing and implementing strategies to improve the revenue cycle. They also work with staff to ensure compliance with federal and state regulations governing the revenue cycle. Finally, they are responsible for taking the Certified Revenue Cycle Professional (CRCP) exam that is administered by the Healthcare Financial Management Association (HFMA).

For more information, check out our Comprehensive Revenue Cycle Flowchart.

What Are The Levels Of Certification For Revenue Cycle Certification?

Revenue cycle personnel must hold at least an associate's degree from an accredited program in some area of public health. This is to ensure that they have the knowledge and skills required to develop, manage, and improve the revenue cycle for healthcare organizations. Then, candidates must submit proof they have two years of experience in revenue cycle management. Finally, candidates must hold a valid CPR/BLS certification, or be enrolled in a BLS course and pass the final exam before submitting their application for the CRCP credential. Here are the levels of certification:

There are a few different types of revenue cycle certification.

Certified Revenue Cycle Specialist (CRCS)

This is the entry-level revenue cycle certification and it offers three different credential levels: basic, advanced, and master. To get an advanced or master's level CRCS credential, you need to have a bachelor's degree from an accredited program in public health or finance. You also need eight years' experience working in the revenue cycle and you must be CPR/BLS certified.

Certified Revenue Cycle Professional (CRCP)

This is the mid-level certification for people who want to work as supervisors or managers within the revenue cycle. There are three different levels of this certification: basic, advanced, and master. To get a basic or advanced level CRCP credential, you need to have an associate's degree from an accredited program in public health or finance. You also need four years' experience working in the revenue cycle and you must be CPR/BLS certified.

Certified Revenue Cycle Executive (CREC)

It is not always clear what is meant by Certified Revenue Cycle Executive, but it is the highest level of revenue cycle management certification. It offers three different credential levels: basic, advanced, and master. To get an advanced or master's level CREC credential, you need to have a bachelor's degree from an accredited program in public health or finance. You also need eight years' experience working in the revenue cycle and you must be CPR/BLS certified.

How Long Will It Take To Get Revenue Cycle Certification?

It takes approximately six to twelve months to get revenue cycle certification. You must complete an accredited training program that lasts up to six months, plus you have to meet experience requirements, pass the CRCP exam offered by HFMA, and clear all other certification requirements. The price of revenue cycle certification varies depending on the level. The lowest level costs $375, while the highest cost is $995.

Revenue Cycle Certification Exams

The certification exams are offered online, but you have to go to an accredited testing site to take them. You can find a list of test sites on the HFMA website. Before taking the exams, make sure you are ready by getting some practice tests at any one of more than 200 sites that offer free CRCP practice exams. There are lots of ways to learn about the healthcare revenue cycle program, so make sure to utilize online resources to best prepare yourself.

They are each graded on a percentage basis, but there is no pass or fail score. To pass an exam, your score must be in the acceptable range for that level of certification. For example, to get a basic level CRCS credential, you need a 70% on the test.

Certified Revenue Cycle Executive

This exam is intended for all senior/executive leaders in the revenue cycle industry, to help equip you for strategic management of the business. It focuses on insurance billing, patient financial engagement, and contract compliance. This certification requires a bachelor's degree in finance, healthcare administration, or public health. It also requires 15 years of revenue cycle experience including eight years in executive or senior-level positions.

Exam Content

This exam tests your knowledge of the following topics:

Applicable laws and regulations as it relates to the revenue cycle

Patient access, billing and payment trends; managed care and insurance billing theory and strategy

Strategic and tactical management of the business model for revenue cycle professionals

Accounting principles and practices as they relate to managing financial activities in a healthcare facility.

Collection procedures, tools, and strategies

Self-pay collections and credit bureau reporting

Patient account resolution procedures, tools, and techniques

Revenue cycle systems applications and software.

Certified Revenue Cycle Professional

This exam is intended for all supervisors and managers in the revenue cycle industry, to help equip you to effectively manage key aspects of the revenue cycle. It focuses on compliance, customer service, and financial management. This certification requires an associate degree in public health or finance. It also requires four years of experience working in the revenue cycle with at least two years of that experience being managerial or supervisory level.

Certified Revenue Cycle Specialist

This exam is intended for revenue cycle staff with responsibilities in patient access, billing, account resolution, denial management, collections, cash posting, customer service, and self-pay collections. It is offered in English, Spanish, Chinese, Vietnamese, and Korean. This certification requires an associate degree in public health or finance. It also requires two years of experience working in the revenue cycle with at least one year of that work being managerial or supervisory level.

Certified Compliance Technician

This exam is intended for all revenue cycle staff who must meet employers’ annual compliance training requirements. It specifically focuses on HIPAA and all federal privacy regulations. It is offered in English, Spanish, Chinese, Vietnamese, and Korean. This certification requires an associate degree in public health or finance. It also requires two years of experience working in the revenue cycle with at least one year of that work being managerial or supervisory level.

Certified Revenue Integrity Professional

The Certified Revenue Integrity Professional (CRIP) exam is intended for anyone in the revenue cycle industry to help ensure that facilities effectively manage their chargemaster, charge description master, and revenue cycles. This is the only certification offered in English. It requires an associate degree in public health or finance.

Revenue Cycle Management Benefits

The benefits of Revenue cycle management bring many benefits to organizations including, but not limited to increased revenue, increased capacity for growth, reduced overhead costs, greater accuracy and reliability of data, improved patient satisfaction scores. Revenue Cycle Management is an integral part of healthcare service providers or facilities.

Integrating multiple systems

Thanks to our white glove revenue cycle management, it consolidates data into one accessible location. Instead of having multiple systems which are not integrated, this process will integrate these together to make information available instantly.

Efficient billing and collections

Once data is integrated it is available for use by the billing department for efficient claim submissions and accurate invoicing. This can be shared with payroll departments seamlessly as well, allowing them to pay accurately and on time. Not only does it ensure the accuracy of finances, but it also reduces billing costs as well. Because it automates billing and collections, it can reduce costs in these areas.

Customer Accounts Receivable

It also ensures the proper documentation is available to payer sources for accurate pre-payment verification submissions which are required by some health plans prior to reimbursement. It includes universal coding modifiers utilized for various transactions within healthcare organizations that are used to ensure codes are assigned correctly.

Facility-wide analysis

Since the data has been integrated, it can be shared and analyzed across all departments and systems, which was previously not possible. This helps with forecasting and budgeting for future expenses and requirements.

Accountable Care Organizations (ACOs)

This certification is CPRC compliant which means that you will understand how the Revenue Cycle impacts the financial performance of an ACO. This is an official accreditation and certification through Advance Healthcare Network (AHCN). The ACHN offers a variety of benefits including educational courses and conferences, networking opportunities, compliance assistance, and health care training.

Security And PCI Standards

The CRIP certification helps to ensure that you meet the standards set forth in the Payment Card Industry (PCI) along with meeting all of the ACA electronic health record (EHR) requirements. The security of this information is vital to ensure financial data is not compromised through various means. It ensures patient confidentiality and protection when it comes to transmitting and importing data from various sources.

Revenue Management Strategies

When it comes to running a medical practice or hospital, it can be very difficult to keep up with all of the necessary tasks and information which needs to be managed. However, by having this certification there are more efficient ways of managing your revenue cycle management activities. Here are a few common revenue management strategies:

Do-It-Yourself RCM

The do-it-yourself method may seem to be the best option at first glance, but in reality, it's not. The time that you have can be limited because of other responsibilities within your organization or practice. There are many areas which need to be looked after and only so much time is available throughout a certain day, week, month, etc. This can cause an increase in human error or incomplete tasks which then hurts the accuracy of your data.

Contracting service providers

This is a more costly method, but it is completed by individuals who are experienced within this area. Outsourcing RCM helps to ensure you receive accurate reports and information at all times. There are many different options available when it comes to choosing a service provider as well. However, it doesn’t make sense to outsource healthcare RCM under certain circumstances, so be careful when considering doing so.

Team collaboration

There are many benefits to team collaboration when it comes down to running your medical practice or healthcare organization successfully. It ensures that there is communication and feedback throughout the entire revenue cycle management area, which then helps to increase the accuracy and efficiency of information and processes within an organization. Information and tasks are sent to the appropriate individuals when needed and then the tasks are completed in a timely manner.

This can be done with our RCM, which can dramatically increase productivity as there are several automations that make the process easier, more accurate, and that can limit your liability. Not only does it make collaboration more effective, but it also makes your team more powerful and efficient.

In order to be successful, you have to have a solid strategy in place that will help your organization stand out among its contenders. In this competitive market, it can be difficult to get by without a plan in place for achieving success. Healthcare organizations need strong leadership in order to help them succeed. Many organizations choose to work with a coach or expert within the industry who has already successfully helped other healthcare businesses achieve their goals.

Final Notes:

With the help of healthcare experts, you can get revenue cycle certification. The best way to do this is by checking out Enter.Health for their rcm solution that provides everything needed in order to be compliant. If you’re looking for a company with great customer service and affordable pricing they are the ones to go with!

People have also asked: 

What is the best revenue cycle certification?

The best revenue cycle certification will be the one that best meets your organization's needs. Some people choose to work with an expert in this area because they have a valuable understanding of how these processes work and you can learn from them in a short period of time that would normally take months or years for someone else to learn.

How much does a certified revenue cycle representative make?

The salary for a certified revenue cycle representative can vary depending on several factors. Most of the time this will depend on where the person works in the United States and what type of experience they have when it comes to running a medical practice or hospital. The hiring manager typically looks at things such as education, years of experience, certifications, etc. when hiring for this position.

What are the secrets to getting certified?

There are many things that go into becoming successful when it comes to running a medical practice or hospital, but the biggest factor is having the right certification in place. The revenue cycle certification will show prospective employees and business partners that your organization is committed to excellence at all levels.