7 KPIs to evaluate RCM services for hospitals

Measuring and analyzing KPIs is a great way to track your performance in revenue cycle management. With more than one department involved in the end-to-end billing process, it is crucial to focus on each segment separately. This way you can integrate the different independent islands of the revenue cycle management in your healthcare organization.

• Self-pay Cash Collection at Point of Service:

There are various tools to measure the collections from patients at the point service. This includes the time from the beginning of the service for co-pays and deductibles to a fixed extent of time after the services are rendered.

• DNFB:

DNFB stands for days in total discharged not final billed. This metric is extremely beneficial in tracking the loopholes and issues in your current workflow. Divide the amount due in DNFB by the average daily gross patient service revenue to get the metric. This metric will help you determine whether there is an issue of delayed billing in your organization.

• Bad debt tracking:

You need to track the bad debt that your health organization is reeling under to ensure that similar issues do not crop up in the future. As the bad debt value goes up, it shows a red flag to ascertain loopholes in your financial services. It is also an indicator for lack of transparent communication with the patients regarding the financial services.

• Trend in Cost to Collect:

The HFMA defines the cost to collect as the total cost of the revenue cycle divided by the total cash collected in the cycle. The goal of the healthcare organization is to reduce the cost to collect for better financial management. Revenue cycle leaders across the USA are measuring this trend to determine the efficiency level of their teams.

• Changes in Resolve Rate:

The resolve rate is the number of claims that get reimbursed by the insurance company divided by the total number of claims during a specific time period. According to surveys, a provider needs to spend at least 10 to 30 minutes working on each claim. If the graph moves upwards, it means that your billing team is efficiently doing a great job taking care of the revenue. Experts believe that a flat line on the curve could indicate issues with credentialing, patient eligibility verification process, and coding.

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