Medical Billing: Full Revenue Cycle Exam Questions — Flashcards

Revenue Cycle Management (RCM) is the end-to-end workflow from patient registration → eligibility → authorization → coding/charge capture → claim submission → payment posting → denials/appeals → patient billing → collections/compliance. Exam questions usually test what step comes next, who owns the task, and how errors create denials or compliance risk.
 

Worked example (mini):
A claim is rejected with “Invalid member ID.”
 This is typically front-end / eligibility / registration data (not coding).
 Fix: verify eligibility, correct member ID, resubmit (often as a corrected claim depending on payer rules).