Monitoring revenue cycle performance is increasingly important for hospitals and health systems, physician organizations, ambulatory providers and integrated delivery systems as they aim to collect every dollar they are owed for their services.
To do this, organizations use a variety of key performance indicators.
Some organizations track certain KPIs more than others, based on their individual payer mix, location and other factors. But the Healthcare Financial Management Association recommends that organizations pay attention to 29 "strategic" level metrics, which are designed for long-term trending and oversight.
They are:
1. Aged accounts receivable as a percentage of total billed accounts receivable
2. Aged accounts receivable as a percentage of billed accounts receivable by payer group
3. Aged accounts receivable as a percentage of total accounts receivable
4. Aged accounts receivable as a percentage of accounts receivable by payer group
5. Remittance denial rate
6. Denial write-offs as a percentage of net patient service revenue
7. Bad debt
8. Charity care
9. Net days in credit balance
10. Clean claim rate
11. Late charges as a percentage of total charges
12. Net days in accounts receivable
13. Cash collection as a percentage of net patient service revenue
14. Uninsured discount
15. Uncompensated care
16. Case mix index
17. Cost to collect
18. Cost to collect by functional area
19. Percentage of patient schedule occupied
20. Pre-registration rate
21. Insurance verification rate
22. Service authorization rate — inpatient and/or observation
23. Service authorization rate — outpatient encounter
24. Conversion rate of uninsured patient to third-party funding source
25. Point-of-service [POS] cash collections
26. Days in total discharged not final billed [DNFB]
27. Days in final billed not submitted to payer [FBNS]
28. Days in total discharged not submitted to payer [DNSP]
29. Total charge lag days
Click here for details about these metrics.
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