Medical billing services in the USA improve the revenue cycle management process by using the latest billing techniques. According to Kaufman Hall study of CFOs from more than 350 hospitals in 2018, the priority of the physicians is to reduce the cost of care delivery.
A MIPS qualified registry collects data in this context along with the information about the quality of services. QPP 2018 has everything in favor of the physicians monetarily and patients in terms of their best treatment. Follow P3Care on LinkedIn – https://www.linkedin.com/company/p3-healthcare-solutions/ to stay updated with the US healthcare industry.
Key performance indicators (KPIs) give us an idea of how much money healthcare services invest in high-quality medical facilities for the patients.
In addition, we know about the profits they earn in return. Today, medical billers don’t use papers to manage patient’s information, but billing software and the electronic health records (EHRs) provide the necessary assistance.
Billing software along with handling information generates reports as per the required functionality. How a medical billing practice contributes to the progress of healthcare professionals and effectively maintains the revenue cycle management process depends on the software as well. It becomes easy for a MIPS qualified registry to collect the relevant data without redundancy.
Given below are some types of reports that will inform you about the progress of the revenue cycle management process.
1. High-Level KPI Report
This report helps in learning about the Current Procedural Terminology (CPT) in medical coding. It confirms that the medical coders use the most common and profitable codes in a medical claim.
This report estimates the following parameters:
• Total encounters
• Total collected payments
• Accounts receivables
• Number of procedures
The difficulties in these KPIs help in knowing the areas that need improvement. For example;
If in a month, cost consumption increases, profit for that month should also increase in the same ratio. You experience a reduction in the accounts receivables (ARs).
Generally, medical billing software conducts everyday tasks of medical billing and coding in an efficient manner. The software has an inbuilt template for CPT, and if there isn’t, you must create one to promote future accurate claim creation.
2. Per-Encounter Reimbursement Report
Another KPI is to compare the reimbursement rates with that of your competitors. The formula to calculate the rate is simple – It is per-encounter reimbursement which is the total payment divided by the total number of encounters in a specific time.
When we know the average reimbursement rate per patient, it improves the consistency of the revenue cycle management process.
3. Report To Keep a Track of Accounts Receivables (ARs)
Revenue cycle management becomes more efficient when we keep a track of accounts receivables for the physicians. Ordinarily, medical billing and coding agencies neglect accounts receivables which exceed 120 days.
However, professional medical billers know the periods for particular claims – 30 days, 60 days and so on to keep an eye on the amount due by the insurance companies. If payments cross the 120-days mark, medical billers find out the exact reason for the delay and join heads to figure out a solution.
When the AR is less than 10%, it represents an ideal situation. If it is more than 25%, drastic changes in the revenue cycle management or a medical billing audit may be the ultimate remedy.
4. Report for Checking the Ratio of Net Collection
By the net collection rate, we know the exact performance of the revenue cycle management system. It highlights whether we are collect payments as per the number of resources we utilize or otherwise. Medical billing practices aim for 95% of revenue collection to progress in the healthcare industry. If the ratio is lesser, there is a room for improvement in the RCM.
Charge value is an important parameter and it is the contractual adjustment of the total billed amount. By knowing this value, billers can calculate the total collected amount and give an estimate of the profit.
We can’t measure the performance of practice unless the billing system works on specific lines of improvement. Ineffective billing directly reflects in your revenue at the end of the day.
Revenue, in general, experiences turbulence with little or no increase in it. The statistical reports mentioned in this article breathe life into the process of revenue generation from the start to finish.
P3Care holds a respectable status in the medical billing and coding field. Call us for a free RCM consultation 1-844-557-3227.