Healthcare practices large and small are subject to the same accounting pitfalls as any other business: The numbers “on the books” never seem to match the hard dollars entering the bank account and not in a good way. That financial shortfall is commonly termed leakage.
As the American healthcare landscape continues its rapid post-ACA evolution toward outcome-based care, higher patient volumes and shrinking margins mean practices are scrambling to nail down every last incoming dollar. And to achieve optimal A/R, that means combating leakage is now priority #1.
Locating the Leaks
Depending on a practice’s administrative structure, the causes of revenue leaks can vary. Here are some common sources we’ve encountered from our customers:
- Sloppy Administration. This includes improperly-trained staff, inconsistent or outdated office procedures, inefficient patient registration or falling behind the changing health insurance paradigm to value-based care.
- Small Balance Accounts. Properly tracking growing numbers of smaller accounts can become as frustrating as herding cats! The more of these balances on the books, the more they tend to fall through the A/R cracks.
- Patient Socioeconomics. The influx of new patients via the ACA means office staff must navigate an even more complex maze of payment calculations copays, deductibles and coinsurance every patient seemingly has their own unique payment “equation.” Errors or incomplete registrations create nagging A/R headaches down the line.
- Denials. Most insurance denials for justifiable medical procedures typically result from needless administrative errors incorrect ICD10 coding or simple data entry glitches.
In today’s healthcare industry, every incoming dollar is important. How can practices find that competitive edge to collect the full revenue they’re entitled to?
Your A/R Secret Weapon: Actionable Metrics
Too many underperforming practices struggle to understand why their bottom line never quite measures up to projections. We’ve identified several key performance indicators (KPIs) which, when analyzed and corrected, often make a dramatic A/R difference for our customers:
- Days In Revenue Outstanding (DRO) This metric typically reflects the overall health of your collections department. Even more pinpoint insights can be achieved from a “360-degree” DRO, cross-referenced by contract type, service/procedure, denial rates, or individual staff members’ performance
- Percentage Of Pre-Registered Accounts Measuring performance of both inpatient and outpatient services, this metric tracks the ratio of patients receiving care before set appointment dates. It’s a yardstick of administrative efficiency within an outcome-based revenue model.
- Balance of Patient Payments Point of service collections from patients-co-pays and deductibles can add up to a quarter or more of total revenue. Comparing original projections against actual cash collected (per patient, procedure or payor) will form a baseline to shore up A/R operations wherever needed.
Cutting Through The Clutter: Advanced Analytics
Metrics and statistics abound, but how can a medical practice tie them together into a coherent, practical format? That’s where Infinx and our advanced revenue cycle management (RCM) solutions come in-delivering convenient, dashboard-based customized analytics to fine-tune your A/R operations, eliminate leakage and maximize profitability.
To learn more about analytics and more advanced Infinx RCM solutions for your practice, contact us today.