Modern data enable ASCs to make fine-tuned adjustments that build an efficient workforce. Yet, practices routinely fail to identify critical areas that need review. Far-sighted providers will spend significant time researching how to best gauge invoicing proficiency.
Key performance indicators (KPIs) are measurable standards that an ASC should track over time. Failing to set and observe appropriate KPIs will obscure a practice’s performance.
Here are some of the most critical billing standards:
● Clean Claims Percentage: A high clean claims percentage indicates billing precision. Review industry data to determine what claim acceptance rate is acceptable for your practice.
● Annual Changes: Comparing quarters across years gives practices a broad overview of their financial performance.
● Long-Lasting A/R: Experts suggest keeping the percentage of A/R over 90 days below 15%. If your practice exceeds this threshold, your billers may have prioritization problems.
● Days Sales Outstanding (DOS): DOS is the average number of days spent in A/R. High DOS implies your team is behind on patient engagement.
● Days to Bill: Billing delays often translate to inflated DOS, time-sensitive denials, and write-offs.
● Days to Pay: Knowing which insurers take the longest to pay creates an invaluable chart. Slow payers may need contract adjustments or specialized invoicing procedures.
● Write-Off Percentage: Write-offs frequently occur because of failures to follow basic regulations. Excessive write-offs should make practices redesign their billing structure.
An efficient ASC should avoid gaps where facilities or workers are idle. Unfortunately, scheduling failures often leave staff unengaged, even during busy quarters. This lag can lead to billing teams having little work one week, then too much the next.
Make notes each time scheduling failures slow workflow. Review this record at the end of the month. This process will reveal how much avoidable downtime your practice accrues monthly.
A lack of denials does not guarantee that billers are securing maximum returns from payers. Insurers will never press practices for the privilege of paying more. So, providers must audit billers to determine how well they understand contracts.
Gauge staff’s contract familiarity by monitoring when they request additional details. Waiting until submission deadlines before seeking necessary documents indicates poor payer understanding.
Many errors occur because of communication breakdowns between providers and invoicing staff. Internal audits should review physician notes to ensure they supply billers with necessary, clear information. Digital records simplify communication standardization and note inspections.
Measuring in-house billing effectiveness requires significant time and energy. To eliminate this burden, professional invoicing companies deliver regular reports that detail their performance. These statements show claims, timelines, and amounts secured. So, providers have all the information necessary to determine whether billers satisfy their standards.
Plutus Health maintains clinical records and provides regular reports outlining our work. This precision has consistently earned us high returns and numerous accounts. As a result, our certified ASC coders have solidified their skills, fortifying practices’ income. Connect with us, so we can walk you through our financing options.
1. Regularly track key performance indicators.
2. Mark scheduling failures as disruptions to your billing workflow.
3. Audit insurance contract knowledge.
4. Review communication between providers and invoicing staff.
5. Professional billing services routinely report their performance.
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