Medical professionals can determine the success of their work in a variety of ways. Patients feel better, lab results arrive quickly, and x-rays and scans show the diagnostician exactly what’s going on. But how do you keep track of the practice’s or facility’s financial success?
Medical bills Key Performance Indicators (KPIs) are indicators that every business owner should pay attention to. It’s not all about the money when it comes to health care. You can’t stay in business if you can’t pay your employees, get supplies ordered, and keep your equipment serviced. You can’t help anyone that way!
Medical Billing Key Performance Indicators
Hospitals have their own set of KPIs, such as bed occupancy and average hospital stay. Still, we’ll concentrate on the medical billing KPIs that a healthcare billing company can help you track and use to improve your business management.
KPIs for the healthcare revenue cycle provide a rapid snapshot of your data. However, monitoring trends and achieving goals is where the actual value lies. While knowing that your bill was $100,000 last month is useful, it’s also crucial to understand how that compares to past months. Your KPIs should be heading in the right direction. So, if you’ve been billing $80,000, a hundred thousand dollars is a terrific indicator. However, if you’ve been billing considerably above that for the past few months, you’ve got a red flag and need to figure out what’s going on.
The following are some of the most significant KPIs to keep an eye on:
For many, this is the most obvious measure, and it is simple to track, but there are a few factors to bear in mind. It’s simple to look at your bank statement and see how much money has grown, but that’s just part of the story. You are most likely paid by insurance, government contracts, and patients. Each of these revenue streams should be examined separately. Because maintaining each one necessitates distinct actions, and the causes of increases and declines will vary.
The duration between giving service and receiving payment in medical A/R is measured in days. It’s also a good idea to separate receipts from patients and other payers. We expect this number to continue to fall as we manage A/R accounts until all old accounts are under control. This statistic can be improved by efficiently reporting claims, following up on denials, and having clear interactions with patients.
Time of Payer Reimbursement
The time it takes for insurance companies and government programs to pay you is included in the days in the A/R metric. There’s another reason to keep track of how long it takes for refunds to arrive. You could notice that one payer takes longer than the others. This alerts you to contact them and confirm that there are no problems with your contract or the submission procedure.
Over 90 Days A/R
Another useful indicator to examine is the percentage of claims and bills that have been in A/R for 90 days or more. The longer a bill stays unpaid, the less likely it is to be paid in the future. Implementing methods to increase billing and collection efficiency should help to lower this percentage. Some healthcare billing businesses will advise you that a bill isn’t worth pursuing after 120 days. However, we have been successful in clearing claims/bills that are up to a year old. We find that once we adopt our system for swiftly submitting and tracking claims, considerably fewer reach the 90-day milestone. However, the metric remains a good predictor of our system’s success.
Claim Denial Ratio
The number of denied claims is an excellent measure of not only the competence of your billing team but also of your company’s overall financial health. Every claim denial represents possible lost income and a reduction in revenue for you. Because there is a cost involved with processing and resubmitting the claim. Using a competent healthcare billing business will boost this metric significantly. If this ratio ever rises, it is a warning indicator that there is an issue with your system. Questions to ask include whether the codes have changed or whether new workers have been hired who are inexperienced in your field and require more training.
There are other KPIs that can be considered. The five aspects above, on the other hand, give a good overview of useful metrics in medical billing. That will significantly change your perception of your revenue and whether it is improving or urgently requiring repair.
“The Medical Billing” Gives KPI Reports as Frequently as You Need Them
Medical business owners must track their healthcare revenue cycle KPIs frequently for the reasons stated above. Outsourcing medical billing has become a source of stress for some physicians. Because the owner of the business does not have access to their financial records. How confident can a company be in employing new employees, upgrading equipment, and so on if they don’t know how much money they’re losing due to outstanding claims or old accounts receivable?
Regularly giving intelligible reports is part of TMB’s commitment to communicating with our clients. The client has control over how frequently this occurs. Most people who run a medical practice can’t afford to review financial records daily. On the other side, having access to critical KPIs in medical billing only once a month may make some business owners feel that they don’t have a stronghold on their money.
Reports are typically reviewed on a monthly or biweekly basis. This gives people the feeling that they are keeping a responsible check on things without committing more time to paperwork than practice. Another excellent strategy combines a fast weekly update with a detailed monthly evaluation. As a result, making sure nothing major falls through the cracks while also ensuring that reviewing reports does not become an energy drain.
Benefits of Hiring a Healthcare Billing Company
If you use an in-house biller, you may have software that can generate a report with graphs displaying your key performance indicators (KPIs). However, how the measures relate to one another and what causes some of the changes may be unclear. A reputable healthcare billing provider should have experts who can assist you in interpreting the results and determining where changes are required.
A good medical billing provider will also be able to help you streamline your front-end procedures. They will also ensure that insurances are validated, permissions are obtained, and supplementary insurance is discovered. Assuring that you profit from all available sources of income.
“The Medical Billing” TMB has worked with practices, labs, and diagnostic facilities all over the country as a healthcare billing service with over a decade of experience. When our clients refer to our reports that highlight their healthcare revenue cycle KPIs, they can immediately understand how useful our services are. Request a demo by clicking here. Find out how we can increase your revenue and relieve you of a lot of paperwork.