Optimize Your Healthcare Revenue Cycle with Staffingly’s Comprehensive RCM Solutions
Maximizing Financial Health: Key Healthcare RCM KPIs for Optimal Revenue
Healthcare providers face complex challenges in managing financial sustainability. A robust Revenue Cycle Management (RCM) system is critical to ensuring that earned revenue is effectively captured, billed, and paid, safeguarding the financial well-being of hospitals and clinics.
Tracking and optimizing key performance indicators (KPIs) within RCM is essential for identifying areas of strength and opportunities for improvement. Below are five critical KPIs to monitor for a strong, financially healthy revenue cycle:
1. Days Not Final Billed (DNFB) ??
The longer claims stay unbilled, the greater the risk of delayed or uncollectible revenue. High DNFB rates point to inefficiencies, whether from incomplete records, coding issues, or billing errors. By maintaining DNFB below five days and addressing bottlenecks, healthcare organizations can significantly improve cash flow.
2. Clean Claim Rate ??
This KPI reflects how effectively your organization submits error-free claims on the first attempt. A high clean claim rate minimizes rework, reduces denials, and accelerates reimbursement. Strive for a rate in the high 90s by implementing robust coding protocols and leveraging technology to streamline processes.
3. A/R > 90 Days by Payer ??
Accounts receivable over 90 days is a red flag for delayed reimbursements or unresolved payment disputes. Monitoring this metric and maintaining it below 30% can help pinpoint inefficiencies and strengthen payer relationships. Automated workflows can further optimize A/R performance, leading to faster payments and reduced write-offs.
4. Denial Write-Off Percentage ?
Denials are inevitable, but excessive denial write-offs can hurt your bottom line. Keeping denial write-offs between 1% and 3% of net patient revenue (NPR) ensures a healthy RCM. Automating root cause analysis for denials helps prevent future issues, increasing cash flow and reducing lost revenue.
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5. Point-of-Service Collections ??
Collecting payments at the point of service improves cash flow and reduces bad debt. With the rise in high-deductible health plans, effective POS collections are essential. Organizations should aim for 1% of NPR in POS collections by offering clear payment options upfront, improving patient experience, and reducing long-term collection efforts.
At Staffingly, Inc we specialize in providing comprehensive RCM outsourcing services, including:
Our services are designed to ensure your organization operates smoothly, with optimal financial performance and efficiency.
With expertise in delivering a quick turnaround time (TAT) and highly trained staff, we ensure that your organization achieves optimal financial performance and operational efficiency.
Contact us today for your RCM solutions:
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Let us help you streamline your revenue cycle and improve your financial health!
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