Revenue Cycle Management

By: Michelle Netoskie

In an industry with rising costs and decreasing reimbursement, taking an in-depth look at revenue cycle management (RCM) can be enlightening. An often-overlooked area of the RCM is key performance indicators (KPI) of the efficiency of the workflow of the revenue cycle. Days in A/R tells part of the story. Using KPI and report data allows managers to transform data into action. Below are the top 10 reports practice should be running weekly and monthly to determine the effectiveness of the current workflow and identify areas of improvement.  

  1. Percentage of co-pay collections at check-in/checkout.
  2. Refunds pending in the Practice Management System, both insurance and patient.
  3. Patient’s past balances collected at today’s appointment.
  4. Claims denial rate by reason code.
  5. Claims rejection rate at clearinghouse by reason code.
  6. Completion of documentation to charge posting.
  7. Charge posting to billing lag time and payment posting lag time.
  8. Lag time of working rejections and denials.
  9. Productivity of Charge entry, A/R team and coders by day, week and month.
  10. Success rate of working denials and appeals.

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