Key Performance Indicators (KPIs) are important metrics to evaluate the performance of a hospital revenue cycle partner. These KPIs help you assess the effectiveness of their services and whether they are delivering value to your organization.
It's important to work closely with your partner to define KPIs and establish clear benchmarks and goals. Regularly reviewing these metrics will help ensure that your hospital revenue cycle partner is meeting your expectations and helping you optimize revenue collection.
Below are the KPIs we believe you should be tracking for your hospital revenue cycle partner.
Appeal Success Rate: Track the success rate of appeals made on denied claims. A higher success rate means the partner is effective at recovering revenue from initially denied claims.
Compliance and Audit Performance: Evaluate the partner's adherence to regulatory and compliance requirements. Does the partner share QA results?
Contractual Adjustment Accuracy: Examine how accurately the partner calculates contractual adjustments. Accuracy in this area is crucial for revenue integrity.
Productivity Metrics: Monitor the productivity of the partner's staff, such as the number of claims processed per employee, which can indicate their efficiency.
Aging of Unresolved Claims: Track the aging of claims that are not yet resolved or have not been paid. An increasing trend here may indicate issues in claims follow-up.
Payment Lag: Measure the time it takes to receive payments from payers. A shorter payment lag indicates a more efficient revenue cycle.
Cost to Collect: Calculate the cost incurred by the partner to collect a certain amount of revenue. This can help assess the efficiency of their revenue cycle management services.
Interested in learning more? Let's talk about how we can optimize your revenue collection. Contact us today!