12 Key Performance Metrics (KPI's) Every Medical Billing Team Should Track - MedReck BPM
MedReck BPM emphasizes the importance of key performance indicators (KPIs) and metrics in enhancing revenue cycle management (RCM) within the realm of medical billing in the United States.
Below are 12 KPIs and metrics that should be taken into account, organized into fundamental areas of RCM.
1. Days in Accounts Receivable (A/R)
Assesses the typical duration, in days, required to receive payment following the delivery of a Treatment.??
MedReck BPM Team Objective standard: 30-40 AR days from Billed date.
??
2. First Pass Resolution Rate (FPRR)
Proportion of claims approved upon initial submission without requiring resubmission or appeal.
MedReck BPM Team Objective standard: 85 to 90%
??
3. Net Collection Rate (NCR)
Assesses the efficiency of collections by evaluating net revenue following adjustments.
MedReck BPM Team Objective standard: 95%-98%.
?
4. Claim Denial Rate
The proportion of claims rejected by payer’s highlights inefficiencies in billing procedures or inaccuracies.??
MedReck BPM Team Objective standard: Less than 5%.
?
5. Denial Resolution Rate
Assesses the effectiveness of correcting and resubmitting denied claims for payment.
MedReck BPM Team Objective standard: 85%-90% & TAT – 24 Hours
?
6. Charge Capture Accuracy
Guarantees that all services rendered are accurately documented and invoiced, thereby reducing the potential for revenue loss.
MedReck BPM Team Objective standard: 98%+ accuracy.
?
领英推荐
7. Point-of-Service Collection Rate
This metric assesses the proportion of payments received at the time of service in relation to the total amount due.??
MedReck BPM Team Objective standard: 90%+.
?
8. Cost to Collect
The proportion of overall revenue cycle expenses to total collections, indicating the effectiveness of the revenue cycle team.
MedReck BPM Team Objective standard: Less than 3%-4%.
?
9. Bad Debt Write-Off Rate
The proportion of AR Accounts that are deemed uncollectible and subsequently written off.??
MedReck BPM Team Objective standard: Less than 3%.
?
10. AR DAYS by Payer
Assesses the distribution of accounts receivable according to the aging of payers, categorized into intervals such as 0-30 days, 31-60 days, and 61-90 days or more.?
MedReck BPM Team Objective standard: No more than 15% of A/R should be 90+ days old.
?
11. Patient Payment Rate
The proportion of PT RESP amounts that are collected contributes to the reduction of outstanding patient debt.?? –
MedReck BPM Team Objective standard: 85%-90%.
?
12. Clean Claim Rate (CCR)
Assesses the proportion of claims submitted accurately, thereby minimizing the likelihood of denial or delay.?
MedReck BPM Team Objective standard: 95%-98%.
Through consistent monitoring and evaluation of these key performance indicators, MedReck BPM can sustain an efficient revenue cycle, enhance financial outcomes, and guarantee a robust cash flow for its clients within the United States medical billing industry.
If you are looking for New or Change in your current billing services. Write us your details to [email protected] or Click here to reach us easily. Our team will reach you immediately for details discussion and provide free AR Analysis report.