If you want to meet operational and financial goals and create a roadmap for your medical practice in a shifting landscape, start tracking these medical practice revenue KPIs.
1. The A.R. Aging Reports
Of course you know that claims are getting denied and your billing team is following up on them. But have you arranged your AR into buckets based on the number of days they’ve remained unpaid? Your largest claim summary should fall in the 30 days bucket or trying to convince payers to reimburse is going to be an uphill task. But how do you know if you are not keeping track of your unpaid claims?
A detailed aging AR report that breaks down key components such as number of claims denied, denial pattern, and payer specifics will enable you to handle backlogged revenue efficiently.
Pulling such reports will help you find out the billing performance metrics and hence help you know how your billing department performs.
2. Patient payments- The most challenging job for a practice!
The responsibility of the front desk staff gets even tough when the patients don’t listen or the staff doesn’t keep a track of patient collections. To make the patient listen to what you need them to understand, it’s better to keep a track of the collections. It becomes a support for you if you have a report handy. Let’s say a dashboard that can help you keep a track of this indicator and thus prove your productivity.
3. Productivity report of each physician
This is the age of ACOs. As medical practice converge under a single umbrella to better manage costs and operational bottlenecks, it is more important than ever to analyse the productivity of every physician on board. It will help you monitor fluctuations in physician productivity metrics and make physicians who are a part of your network more accountable. This adds to the list of practice financial performance metrics you should be tracking.
4. Net monthly collections
You are meeting patients every day, but are you getting paid for each patient visit? Monthly net collections is calculated as (Payments – Credits) / (Charges – Contractual Adjustments). It reflects the amount of dollars you’ve collected and conversely the amount of potential revenue left on the table. A concise report will help you understand the practice financial performance metrics and areas that need to be improved on.
ICD-10 has transformed the way healthcare organizations code. It demands greater accuracy and granularity of data. A detailed medical coding report will help increase coding throughput and spot the cracks in your medical coding process.
Keeping track of the reimbursement rate of each payer is essential. Monitoring reimbursement metrics will enable medical practices reach financial goals. Getting to know how each payer reimburses your practice can help you design an effective financial plan and fix the leaks in your revenue cycle. Most practices miss out this indicator and the payer gets a chance to change its payment trends or even deny a claim without a valid reason. It is also important to monitor the reimbursement TAT of insurers
The above dashboard displays the reimbursement TAT for last 12 months. You can select from the other two tabs (For 3 months and 6 months).This is also very important when considering to track the medical practice revenue KPIs
If you have questions or comments about this article please contact us. Comments that provide additional related information may be added here by our Editors.
Skilled Nursing Facility Provider Preview Reports: Review by November 14 - Help Your Patients Make Informed Health Care Decisions - Ambulance Fee Schedule: CY 2023 Ambulance Inflation Factor & Productivity Adjustment - Compliance - Implanted Spinal Neurostimulators: Document Medical Records - Claims, Pricers, & Codes...
Congratulations on a successful 2021 implementation of the Evaluation and Management (E/M) changes! That was a big change, but now an even bigger change is headed your way for inpatient and all other E/M categories. How great is it that almost all of the E/M categories will now be scored based on medical decision making (MDM) or total provider time? Standardized scoring and one set of E/M guidelines has the potential of bringing about a change or improvement of provider fatigue due to over regulation and documentation burden.
AHIMA released its CDI Practice Brief Monday. At Yom Kippur services, I found myself thinking about the question Dr. Ronald Hirsch posed to me the day before. My rabbi was talking in her sermon about the difference between halacha and minhag. Halacha is law; it is the prescriptions...
View the ICD-10-CM Guideline Changes for 2023 Chapter 19 (Injury, poisoning, and certain other consequences of external causes [S00-T88])The guidelines clarify that coders do not need to see a change in the patient’s condition to assign an underdosing code. According to the updated guidelines, “Documentation that the patient is taking less ...
Palliative care is often considered to be hospice and comfort care. Palliative care is sometimes used interchangeably with “comfort care” and then again sometimes with “hospice care.” But these terms do have slightly different meanings and sometimes the meaning varies depending on who is stating it. The National...
In 2022 there were 159 new codes; the 2023 ICD-10-CM code update includes 1,176 new, 28 revised, and 287 deleted codes, a substantial change from last year. The 2023 ICD-10-CM codes are to be used for discharges from October 1, 2022 through September 30, 2023, and for patient encounters from ...
If you’ve been in any healthcare role for more than two years, you’ve seen quite a bit of change. And guess what, it’s not over. We are living and working in uncertain times. This climate requires each of us to step outside of our comfort zones to lead exactly where we stand. It’s not required of one to have a “title” to lead. What is required, however, is a willingness to trust your instincts, look for answers and rely on your team.