kpi webinar deck 11 2016 final
TRANSCRIPT
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2016 Webinar Series:
5 KPI’s for Financial Success
To listen to the audio on this webinar, please click on the link below:https://healthcois.webex.com/healthcois/lsr.php?RCID=73fb0eec478d4ac1b75ede603e353351
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The HealthCo Team
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PanelistsKelly McAvoyImplementation Consultant
HealthCo Information Systems
Andrea CunninghamDirector of Services
HealthCo Information Systems
Larry JurgensDirector, Healthcare Consulting
Jurgens & Associates
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Measurement = Success
Setting KPI’s
Select KPI’s that have a clear tie to strategic business initiatives
Ensure your team has control over the KPI’s
selected
Use simple, easy to understand KPI’s that
will make sense to your team
Make sure your KPI’s cannot be manipulated by the team…they need
to be credible
Guidelines
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Measurement = Success
Days In AR AR by Day
Adjusted Collection
Rate
Schedule Maximization
Claim Denial Rate
KPI Categories
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Measurement = Success
KPI Days In AR
Definition
Average number of days it takesyour clinic to get paid
Target*38 Days
Measure
Divide your current receivables, net of credits,by your average daily charge amount
*MGMA National Best Practice Standard
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Poll Question
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How Do We Improve?
Set your goal and measure!
Monitor claim submission timing; daily is the best practice
Identify problem carriers that take more time than your average to pay• Provide action list to staff with narrow group of high impact payers
Utilize your billing system to monitor unbilled or missing charges; visit status is one way to monitor this
Prioritize staff activity and workplans• Centricity Task Management provides a tool for this
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Days In AR
Measurement = Success
KPI AR By Day
Definition
The amount of receivables viewed by daysoutstanding (0-30, 31-60, etc.)
Target*
0-30: 57% 31-60: 12%61-90: 7% 90+: 24%
Measure
Divide your current receivables in each agingbucket by total receivables and multiply by 100
*MGMA National Best Practice Standard
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Poll Question
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How Do We Improve?
Set your goal and measure!
Set payment plans with patients if you are unable to collect in full up front
Break out of the “statement habit” by suggesting credit card payment
Focus on carrier response to claims and if they fall outside 30 day response window
Prioritize staff work by dollar amount and aging bucket to target highest impact claims first; focus your time on your best return
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Days In AR
Measurement = Success
KPI Adjusted Collection Rate
Definition% total available reimbursement collected
Target95%+
Measure
Divide payments, net of credits, by allowablecharges submitted, multiply by 100
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Poll Question
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How Do We Improve?
Set Goals and Measure!
Know your allowable amounts!
Challenge your payors if you see reimbursement below cost; if you don’t manage this you are at the payors mercy
Monitor your payments through reporting to show the variance between contract rates and receivables
Empower your billers to challenge a payment amount
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Days In AR
Measurement = Success
KPI Schedule Maximization
Definition
% of available schedule slots filled with billablevisits
TargetInternal target required
Measure
Divide filled visit slots on schedule by totalavailable for review period (day, week, month)
*MGMA National Best Practice Standard
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Poll Question
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How Do We Improve?
Set Goals and Measure!
Utilize a “recall feature” to get patients back in for services that are overdue
Establish a protocol in your clinic on offering first available appointments
Use a wait list to fill in for cancelled visits
Track no-show rates and re-offenders in your clinic
Consider a cancellation/no-show policy
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Days In AR
Measurement = Success
KPI Denied Claim Rate
Definition
% of claims submitted that have been denied bypayers
Target5% or less
Measure
Divide denied claims amount by totalreceivables, multiply by 100
*MGMA National Best Practice Standard
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Poll Question
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How Do We Improve?
Set Goals and Measure!
Understand the reasons for your denials
Track denial reasons with product like Denials IQ
Utilize claim scrubber to claims out the door clean the first time
Use the data on denials to train staff and keep from repeating the same mistakes
Enable communication between teams working denials and front end billing
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KPI Tracking Poster
To request a free clinic KPI poster: http://www.healthcosystems.com/go/kpi-poster/
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Resources
http://www.medicalpracticeinsider.com/best-practices/keying-kpis
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