With the advent of practice management software, there is no limit to the data your practice can measure.
Deciding exactly what reports and statistics are the most meaningful is important. Your practice will be focused on bottom-line stats like net collection percentages, but your office manager and billing staff may focus on clean claims or how long it takes to capture demographics on a new patient.
Below are some of the most important billing and collections key performance indicators (KPIs). By looking at each stage of the revenue cycle, you can easily spot where you need help the most. Even if you track just a few of these suggested metrics, you’re on the way to making tangible improvements.
Remember: if you don’t track it, you can’t measure it. And if you’re not measuring it, you’ll never be able to make improvements.
Billed amount vs. value at time of charge capture
Gap between date-of-service and date billed
Time-of-data-entry per encounter
Time-of-data-entry per patient
Percentage of claims denied due to front-end edits vs. due to coding oversights
Percentage of claims denied due to authorization/referral, insurance information or eligibility oversights
Collections KPIs Days A/R Net percentage collected, overall and by payer
Percentage of claims denied overall, and by payer
Percentage of no-response claims overall, and by payer
Average life of denials and no-response incidents
Denials by category (over time, a larger percentage should be due to payer error and/or request for further info, not due to practice mistakes)
There are also numerous reports you should use for ongoing management. Break these up by the types of reports you need to see on a daily, weekly and monthly basis:
Review daily activity and net production (Charges – payments – adjustments + Refunds, etc.)
Quantify any billing backlog
Balance over-the-counter collections by source (cash, checks, remittance received, credit cards, etc.)
Quantify payment posting backlog
Quantify collection backlog
Review outstanding A/R (billed, value and days)
Review monthly production by doctor
Review denial activity during month
Review reverse aging of payments (payments received during month for what billing month did they pertain)
It is possible to run a world-class medical practice. Even a limited adoption of tracking and measuring KPIs can yield real results. Remember:
- The patient experience starts at the front desk – loyalty and good collections depend upon execution here.
- Select numerous key performance indicators to manage the practice — monitor them frequently.
- Perfect various reports and use them daily/weekly/monthly to manage the practice – online and print combination is best.
- Enable mobile/remote monitoring of practice.
- Automate functions wherever possible and cost effective
- Outsource non-core functions wherever possible and cost effective
- Spend time and energy treating patients and marketing the practice
- Utilize benchmarking to track utilization by disease
What KPIs are you looking at? Do they help you obtain a better grip on workflows and processes at your practice?
Brian Foster is a Director of Client Solutions at CareCloud with over 20+ years in the healthcare industry. Throughout the 1990s he was the Publisher of a specialized trade paper for healthcare industry professionals. Since 2001, Brian has worked as a senior business development professional, helping medical practices to provide the highest-quality patient care while simultaneously improving revenues. He can be reached at BFoster@carecloud.com or (786) 879-9200.