Revenue Cycle KPIs Practices Should Track in 2018

outsource revenue cycle management services

Tracking key performance indicators (KPIs) does not mean that healthcare providers and practices have to end up drowning under a deluge of them. Picking and choosing what KPIs need to be tracked in a revenue cycle ensures that practices get a clear picture of how claims are handled, whether they are processed successfully or not and their impact on the profitability. Below we help practices identify the top 5 KPIs that need to be tracked this year and look into whether outsourcing revenue cycle management can help make the process smoother, and ultimately ensure better financial stability.

Analysis Report of Denied Claims

Denial of claims adds up and become an huge drain on revenue and in the recent years medical practitioners have seen written off revenue arising from them shooting up by 5.9% in one year alone. Therefore the analysis report of denied claims needs to be monitored frequently. The report’s denial management metrics importantly can then be used to keep denials low by altogether preventing some and reducing the number of hard denials. With the aid of the report revenue cycle management can be fine tuned and improper coding practices or repetitive front office errors resulted in denials can be identified and dealt with.

Turnaround Time on Claims

The number of days a claim takes to be processed and reimbursed does not just depend on the insurer but also on medical providers. Often inaccurate claims slow down the process of them being paid and when turnaround time is monitored these instances can be identified and dealt with. Keeping an eye on this KPI using the submission date and payment date, also helps identify when insurance companies are processing claims slower during the revenue cycle. In these cases effective communication can be employed to get a faster turnaround.

Aging Payer and Patient Accounts Receivable

Coming to Aging Accounts Receivable both in terms of payer and patient, healthcare providers should ensure that around 90% should be collected before the 120 day period is done. When this KPI is tracked as part of revenue cycle management providers can identify whether they need to follow up with patients or payers to get aging payments settled. Once problematic areas such as a lagging patient accounts receivable is identified processes such as eligibility verifications can be done rigorously or handled as part of outsourcing revenue cycle management.

Reviewing Medical Coding

Ensuring correct codes are used on claims is all important as often denials stem from inaccurate codes. To deal with this a report that reviews the accuracy of codes can be run in house or complied by your preferred outsource revenue cycle management partner.

First Pass Resolution Rate of Claims

Keeping track of the percentage of claims that are resolved in the first pass, and ensuring it remains high and ideally above 95% is essential. This is where outsourcing revenue cycle management is useful as experienced partners have highly trained staff in place who ensure that the cost associated with having to rework claims is kept low.

With a right set of KPIs in place healthcare providers can keep a close watch on revenue cycle management and quickly put into place changes to get better results. For additional details related to revenue cycle you can contact revenue cycle management experts like MedBillingExperts. As a fully-fledged revenue cycle management company our eight global delivery centers are staffed with experts who are certified and trained to handle changing rules and regulations, create reports based on KPIs and ensure that claims are handled accurately and speedily.

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