Break out the mint juleps and don your hats; the most exciting two minutes in sports happens this coming Saturday. Skilled jockeys and thoroughbreds will compete at Churchill Downs for the privilege of being blanketed with roses – and cash – at the 2018 Kentucky Derby.
A race-winning strategy at the Downs takes plenty of planning and hard work. Jockeys and savvy race teams use strategies and key performance indicators (KPIs) like speed around the track to help them succeed and find places they can improve. By the same token, being a revenue-cycle front-runner takes considerable preparation and fine tuning. Just like in a race, your office can use KPIs to help drive change and behavior to deliver a winning revenue cycle performance. That said, how do you know which areas your practice should focus on to make the greatest impact?
Here are three tips to help you understand which improvement areas and KPIs you should be targeting to maximize and simplify office performance.
- Identify external opportunities for improvement areas associated with payers.
- Network with other members of your state and local medical group associations to learn how they’re managing and measuring their payer performance.
- Read and consider all your payer communications. Assign an employee to regularly review updates from payers and create internal memos to keep your teams updated.
- Communicate regularly with your provider representatives.
- Identify internal opportunities for improvement. Take a look at how your system is functioning and how your office is handling accounts. One good place to start is sampling open invoices to evaluate how they’ve been touched, what delays occurred, and if it warrants a follow-up. From there you can:
- Identify key areas of improvement
- Implement and use adjustment codes
- Train staff who handle payment posting and follow-up
- Monitor appropriate use via audits
- Review your adjustments. Look at how much your organization is writing off for non-contractual losses. Get to the root of the problem by determining where charge lags happen, documenting the date of service to documentation, to coding, to charge entry and to claim submission. Contrary to popular belief, these losses are controllable, and opportunities are within your purview. Simply use your adjustments as a guide to streamline performance improvements.
Get more insight to help you go the distance and become a revenue cycle front-runner. Learn which specific KPIs can help you tackle these three opportunities in our white paper: Key Metrics in Revenue Cycle Management.