Top Kpis To Measure Revenue Cycle Management Success

By Author: Sarah Jones
Total Articles: 3
Comment this article

The Healthcare sector is rapidly changing. Healthcare organizations are under constant pressure to operate at maximum efficiency while ensuring revenue cycle integrity. The significance of industry standards and comparing the RCM performance to that standard is crucial. It's essential to improve revenue cycle efficiency, identify industry trends and experience a dynamic shift in the right direction.

Revenue cycle management services focus on key categories of KPIs. This includes accuracy, productivity, and reconciliation. KPI helps lower compliance risk and ensure the accuracy of charges. It varies depending on the facility's goals and needs.

In this article, we'll focus on how your organization can make the best out of the cycle. But, first, here's what you must keep a close tab.

Point-of-service collections

The point-of-service KPI helps determine the effectiveness of the POS system. It helps track POS collection relative to payment received before services are rendered, up to seven days later. Healthcare debt recovery services divide the POS payments by the total self-pay cash collected.

It ...
... also helps identify problems in the POS operations affecting RCM. Besides, decreased efficiency may lead to increased collection and revenue loss. Organizations with higher payments require long-term payment options; such metrics may not benefit in the long term.

Clean claim rate

The clean claim rate focuses on inefficiencies and problems in claim submitting and processing. Basically, all rejected claims take a significant amount of time to correct. Now, this might yield charges. The longer offering claims and resolving the allegations, the greater it takes time to determine eligibility and get payments cleared.

Other KPIs relate to claim processing efficiency, and the clean claim rate shows average perfect daily claims that pass instead of the total number of claims.

Bad debt

The effectiveness of collection can be measured with revenue cycle management services. This helps you determine the effectiveness of pre-service financial counseling or other similar programs. Remember, this must not include lost debts. Inefficiency in previous revenue cycle areas is evident by a higher Bad Debt value.

You can find the value once you divide the income statement's Bad Debt by the gross patient service revenue period.

Days in A/R

The days spent in A/R reveal the average time to get paid for services. This value helps determine effectiveness, especially when obtaining payment for services. Here, it totally depends on how well the practice manages Account Receivables.

Revenue cycle management services make the process seamless. The agents will pull information from the balance sheet and income statement and then divide total A/R by the average daily net patient service revenue.

Cost to collect

Cost to collect is a trend healthcare debt collection services have been utilizing for a long time. Moreover, it helps measure efficiency and productivity. The definition here is, Total Revenue Cycle Cost/ Total Cash Collected.

Resolve rate

Resolve rate is why you need the assistance of the RCM process, i.e., eligibility for coding and billing. To find this KPI, divide the total number of claims paid for a specific period by the total number of claims.

Conclusion

A professional organization could develop the KPI by dividing the total collected patient service cash found on the balance sheet by the average monthly net patient service revenue, i.e., which is on the income statement.

If adjustment increases, the net collection percentage results enhance. It ensures that the staff gets accurate posting adjustments is crucial and that accounts are not written off rather than collected or appealed.

It would be best to understand how the revenue cycle management services function. KPIs help you improve your collection.