10 Medical Billing KPIs You Should Be Tracking Right Now

In today's medical billing landscape, it’s not easy to navigate and plan for the future. The transition to value-based care and rising patient responsibility make the management of day-to-day operations challenging. In recent days it’s become even more critical to regularly measure the financial health of your practice as well as your staff and the wellbeing of your patients.

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Medical billing key performance indicators (KPIs) help physicians and management understand the strengths and weaknesses of their revenue cycle in order to help guide future decisions. Tracking KPI’s also help to prioritize resources and recognize key success drivers.

If you're feeling overwhelmed, start with a focus on quality and track KPIs that will heavily impact your financial performance. Here are 10 KPI’s you should track on a regular basis as well as the tools you'll need to turn those numbers into actionable insights.

  1. Patient Wait Time: Calculate the average amount of time a patient waits between checking in and seeing a provider. This KPI can help gauge staffing levels and provide insight into patient satisfaction.
  2. Average Insurance Claim Processing Time & Cost: This KPI tracks what the average amount of time and money an organization spends processing various insurance claims. When the days in AR is low, it indicates that the facility receives payment faster and there is less cost to the patient.
  3. Claims Denial Rate: This measurement provides insight into the effectiveness of the organization's revenue cycle. A low claims denial rate means that the healthcare organization has a streamlined process which leads to more time to focus on patient care.
  4. Average Treatment Charge: If you understand what the average charge is per treatment it gives you an idea of how many treatments you need to make per year to stay profitable. This KPI can be broken down by treatment or shown as an average of all treatments or treatment categories.
  5. Permanent Employee Wages: Adequate and fair wages are a clear measure of staff retention, job satisfaction and employee expense. By tracking this KPI you can separate out wages by administration, and sometimes by direct providers of care.
  6. Overall Patient Satisfaction: By calculating patient satisfaction levels this KPI informs your administration of possible problems lying underneath the surface. This can be a great marketing tool for your organization if it's high, but a low number could signal a problem with other operations or services.
  7. Number Of Mistake Events: If you’re not currently aware of the mistakes your system or personnel are making it’s hard to provide process improvement measures. By tracking this KPI you can easily identify the effectiveness of the employees and the equipment.
  8. Number of Partnerships with Advocacy Groups: This indicator is used to measure the number of partnerships a hospital holds with other organizations. A high value in this indicator implies a greater positive influence from campaigns and events held by the hospital.
  9. Patient Vs. Staff Ratio: This is another key staffing indicator that is worthwhile to track. This KPI provides insight to the number of staff available per patient. May indicate whether the facility is overstaffed or understaffed.
  10. Patient Follow-Up: Are your patients following their post-op procedure orders or needing additional to be readmitted? It’s important to track the number of patients who receive follow-up after their visit to the facility. This could be from a physician, nurse, or other staff member asking about the visit and the patient's improvements to them needing to be readmitted. Whatever the case may be it’s a crucial KPI to ensure your facility is well managed.

The above list is not comprehensive but does show that in selected areas of a healthcare organization there are some measurable indicators that can be used to keep a track of the performance of the institution and its employees. KPI’s should be considered over the long-term with a definition that remains steadfast throughout the organization. The KPI’s can always be influenced by progress and goals set by the organization, as such their value should continue to increase.

The key is organizing your KPIs into dashboards through a business intelligence reporting and analytics tool. This will improve your ability to identify trends and patterns, as well as increase awareness around what variables impact your practice. Receiving medical billing reports on a daily, weekly, and monthly basis will improve your ability to monitor the financial performance of your organization as well as your staff.

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