4 Statistical Reports To Access Revenue Cycle Management

Medical billing services in the US play a major role in the revenue cycle management process. They use the latest health IT tools and techniques to counter day-to-day challenges. According to the Kaufman Hall study of CFOs from more than 350 hospitals in 2018, the priority of the physicians was to reduce the cost of care delivery. Because the healthcare system is becoming more and more price-competitive.

MIPS being part of value-based healthcare has everything in favor of the physicians monetarily and patients in terms of their health. Quality is the number one requirement of this program, and it is judged by weighing doctors in four performance categories. Optimizing the RCM is one way to control the prices of care delivery, and that’s where P3 focuses the most.

Today, physicians or others related to them don’t have to manage patient records on paper, but there is dedicated software for them. As a billing company, we operate on Certified Electronic Health Records Technology (CEHRT) to maintain a steady cash flow for clinicians. In an EHR, data is automated, and we don’t have to worry about digging up a file from underneath a pile of papers.

Given below are some types of reports that will inform you about the progress of the revenue cycle management method.

High-Level KPI Report

This report helps in learning about the Current Procedural Terminology (CPT) in medical coding. It confirms that medical coders use the most common and profitable codes in a medical claim.

This report estimates the following parameters:

• Total encounters
• Total collected payments
• Accounts receivables
• Number of procedures

The difficulties in these KPIs help in knowing the areas that need improvement. For example;

If in a month, cost consumption increases, profit for that month should also increase in the same ratio. You experience a reduction in the accounts receivables (ARs).

Generally, medical billing software conducts everyday tasks of medical billing and coding in an efficient manner. The software has an inbuilt template for CPT, and if there isn’t, you must create one to promote future accurate claim creation.

Per-Encounter Reimbursement Report

Another KPI is to compare the reimbursement rates with that of your competitors. The formula to calculate the rate is simple – It is per-encounter reimbursement which is the total payment divided by the total number of encounters in a specific time.

When we know the average reimbursement rate per patient, it improves the consistency of the revenue cycle management process.

For the surgical procedure, pre-service work defines the physician’s physical work provided a day before the operative procedure. Almost everything is included in it, such as the preoperative evaluation, checking the patient, prescribing medication, and giving medicines to them.

Generally, medical billing services get huge help from this to know what investment clinicians are lending to this part.

Report To Keep a Track of Accounts Receivables (ARs)

Revenue cycle management becomes more efficient when we keep a track of accounts receivables for the physicians. Ordinarily, medical billing and coding agencies neglect accounts receivables that exceed 120 days.

However, professional medical billers know the periods for particular claims – 30 days, 60 days, and so on to keep an eye on the amount due by the insurance companies. If payments cross the 120-day mark, medical billers find out the exact reason for the delay and join heads to figure out a solution.

When the AR is less than 10%, it represents an ideal situation. If it is more than 25%, drastic changes in the revenue cycle management or a medical billing audit may be the ultimate remedy.

Report for Checking the Ratio of Net Collection

By the net collection rate, we know the exact performance of the revenue cycle management system. It highlights whether we are collecting payments as per the number of resources we utilize or otherwise. Medical billing practices aim for 95% of revenue collection to progress in the healthcare industry. If the ratio is lesser, there is room for improvement in the RCM.

Charge value is an important parameter and it is the contractual adjustment of the total billed amount. By knowing this value, billers can calculate the total collected amount and give an estimate of the profit.

Conclusion

We can’t measure the performance of a physician’s practice unless the billing system works on specific lines of improvement. Ineffective billing directly affects revenue at the end of the day. Therefore, it is crucial to have your best personnel in revenue cycle management to keep it in a profitable mode.

P3 works to increase the revenue of physicians in an organized yet efficient way. Because they know the vitality of such an effort. It gives them a chance at increased revenue along with satisfied patients. The statistical reports mentioned in this article breathe life into the process of revenue generation from start to finish.

For a free RCM consultation, call 1-844-557-3227 without hesitation.

As a clinician, why do you think it is important to have an effective RCM process in place?