The number one thing we have recognized about many of our new clients is that in the past they have been completely in the dark when it comes to medical billing data in their practice.
Monitoring your practice’s financial performance when it comes to revenue is critical for your group’s success and ensures that you are collecting what is owed. It also allows you to realize processes that need improving so you can increase your revenue
Some of the reasons that practices aren’t looking at their billing data on a regular basis:
While there are many ways to measure medical billing and collection data, here are some common metrics that may be important for you to ask about:
Clean Claims Rate
This is the percentage of claims that are submitted a single time and paid. This is important to tell you how effective your medical revenue process is.
Days in A/R
This measures how long it takes for a service to be paid and helps you better budget and manage the expenses in your practice.
Percentage of A/R older than 60/90 days
This is another way to view how long it is taking to be paid. If you have a significant of A/R paid greater than 60-90 days then this can increase rejections and write-offs and decrease revenue.
Gross Collection Rate
This metric indicates how close your fees are to the payer’s rates and how your practice is doing with the collection. Each practice will have a different gross collection rate based on the fee schedule. Therefore this may not be a useful metric to benchmark but instead determine if you need to look at your fee schedule.
Net Collection Rate
This metric tells you how effective your practice is at collecting the reimbursement you are allowed after insurance adjustments have been applied. On average this metric should be around 95% of potential revenue for services. You can either collect this from the insurance or the patient.
Contractual Variance
This is the amount you are receiving below the amount that you are able to collect contractually from your payers. This tells you how well your coding and billing process is. This is a very important metric since this shows you where your expected payments should be.
Denial Rate
Write-offs can occur for a few reasons but often from denied insurance claims or the inability of the billing team to follow up on denials. Essentially, this is the metric that shows the effectiveness of your revenue cycle management process. This may vary but for most general practices, this should be 5-10% or less.
Most practice management software provides some key metrics and if you need additional data, you can always use an Excel sheet to track and trend.
If your current medical billing service isn’t providing you with the data you need, you may be missing out on revenue. At National Revenue Consulting, all of our clients receive daily, weekly and monthly data to know the health of their practice. During those first few weeks with a new client, we even expect to meet with the office and help our new clients feel more comfortable with a change in billing provider.
Reach out today for a free consultation by one of our knowledgeable team members
Helping physicians, optimize their practice, increase revenue, and focus on patient care.
6650 Rivers Ave Ste 105 PMB 25206. North Charleston, South Carolina 29406-4829 US
Email us: [email protected]
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