It is important to train your entire staff to understand how their jobs functions affect cash flow. There are many points of entry into the revenue cycle at your practice - Be sure your staff knows all of them:
- Patient access (e.g., scheduling and registration, insurance eligibility verification, and service preauthorization);
- Charge processing (e.g., capturing and coding services and entering data);
- Bill processing (e.g., the production and submission of claims and patient statements);
- Payment posting (e.g., line-item posting or payments and denials/rejections); and
Accounts receivable (A/R) follow-up (e.g., resolution of unpaid insurance, patient-responsible charges, appeal of third-party payer rejections and denials, and collection agency performance)
Realizing where you generate revenue at your practice is the first step to understanding the revenue cycle. The next step is to benchmark your revenue cycle management processes.
Administrators should report and review at least monthly information about 18 performance indicators in order to establish a benchmark with which to compare data. Your initial review of these indicators allows you to quickly spot areas ripe for improvement. Over time, these indicators should serve as quantifiable numbers by which you can measure improvement in your revenue cycle.
___ Percent of scheduled patients vs. available visit/surgery/procedure appointment times
___ Percent of scheduled preregistered patients vs. total scheduled patients
___ Percent of insurance eligibility verifications vs. total scheduled patients
___ Percent of insurance pre-authorizations vs. total required for services rendered
___ Percent of point-of-service collections vs. scheduled patient-responsible balances
___ Average number of missing charges vs. services rendered
___ Average days between service date and charge entered
___ Average days between charge entry and claim submission
___ Percent of presubmission claim errors by category for total claims processed
___ Percent of postsubmission claim errors returned from carriers
___ Percent of denied/rejected claims appealed successfully vs. total denial/rejections
___ Average days between entry of patient-responsible balance and statement processed
___ Percent of undeliverable patient statements for total statements processed
___ Average days between receipt of payment and payment posted
___ Number of noncontractual adjustments taken per claim remittance advice posted
___ Average number of unpaid claims resolved by day per collector
___ Average number of unpaid patient balances resolved by day per collector
___ Average days in A/R
The Oncology Managers' Briefcase contains hundreds of tools for account receivables, worksheets for calculating operational ratios and compensation mixes plus practice management files for A/R and A/R by payer source. Login into the site and type in a few words for a search criteria or click practice management, account receivable, or calculator headers for a complete list in each category.
The revenue cycle indicators above were culled from the blog of Reed Tinsley, CPA. Reed has more than 20 years of consulting experience and written dozens of articles and books, and speaks regularly to healthcare groups and associations across the country.
.jpg)
.jpg)
.jpg)
