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May 14, 2019

The Top 5 Revenue Cycle Management Key Performance Indicators You Need To Track For Success

Gett Johnson has 30+ years of experience in Healthcare I.T. and RCM Professional. His skillset includes being an expert in Healthcare I.T. software and hardware solutions. He is helping health systems, hospitals, ASCs, medical offices, and healthcare organizations become financially healthy by optimizing complete RCM processes.

ABA Providers Recover Dues From Patients To Efficient Your Account Receivables

A solid revenue cycle management (RCM) strategy must track certain key performance indicators (KPIs) in order to understand patterns and optimize processes and flows.

If you manage your revenue cycle yourself or hire in-house office staff for the task, you know how tiresome and tedious it is to create a strategy that runs smoothly and efficiently. Not to mention, that having a weak process in place nearly guarantees touch point mistakes, leading to high rates of avoidable denials and rejections.

Consider the following KPIs as the vitals you need to track to ensure your revenue stream is healthy:

Days in Accounts Receivable

Tracking the days in A/R will reveal how long it takes you to get paid for your services on average. This information is critical in determining the efficiency in this particular point in your RCM workflow, as you’ll discover how long it takes your office to obtain payment for services.

How To Find this KPI: Divide the total A/R by the average daily net patient service revenue. (To get the average daily net patient service revenue, divide total annual sales by 365.)

Denial Rate

If you have a high rate of denials, you’ll need to put certain tactics in place to prevent future rejections, especially since our research shows that up to 90% of denials are avoidable. Document the reasons for denials and then put an action plan in place.

Example: Dr. Fields tracked the top 5 KPIs for his practice and discovered that he had a high rate of denials. After checking past claims and documenting the reason for denials, he realized that there were a high number of errors in coding. After spending a high cost for training material and professional development sessions to train his staff and implementing quality assessment checks on all postings, Dr. Fields’ denial rate was reduced.

Clean Claims Rate

Having a high clean claims rate fuels your practice’s cash flow, so it’s imperative to send out clean claims the first time around. This KPI will tell you whether or not the first touchpoints dealing with patient registration and insurance eligibility in your RCM flow is working accurately and efficiently. Even small mistakes in demographics or insurance information can result in a denial, so be sure to train your staff to quality check information before submitting a claim.

Pending Claims Rate

Check your current rate against last year’s rate. Has it increased, decreased, or remained the same? Your ideal rate is either low or steadily decreasing until you hit your goal. This KPI can give you information on your documentation, authorization, confirmation, billing, and respiratory teams.

Reimbursement Rate

Is your reimbursement rate improving month after month? If so, it means you’re ensuring that patients aren’t paying less than the contracted rates and your staff is properly trained to enter orders accurately the first time. If not, you’ll need to analyze these two touchpoints in your RCM workflow and optimize them.  

Remember, it’s not enough to simply track these data points. After gathering the information, it’s important that you examine the data and find ways to strengthen weak points in your process and optimize it as much as possible.

The fastest, easiest, and most cost-efficient way to track these KPIs and optimize your process is by partnering with an outsourcing RCM solutions firm like Plutus Health.

Not only do our RCM experts create optimized workflows for practices and specialty labs, but we do it using Zeus, our robotic processing automation software offered as a service. Enjoy more time to focus on patients and more money when you save on overhead costs by allowing us to create an end-to-end RCM strategy that will track these 5 vital KPIs to increase the health of your revenue stream.

Connect with a Plutus Health representative today to learn how our rcm services can help your practice or lab eliminate human error, decrease overhead costs, and increase your revenue.

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Faq

What are the top workforce challenges facing ABA therapy providers in 2025?

ABA providers are grappling with high staff turnover (up to 65%), rising burnout, administrative overload, and stagnant reimbursement rates. These challenges directly impact care continuity, clinical outcomes, and operational performance.

How does operational inefficiency affect ABA organizations?

Operational inefficiency costs ABA teams up to 10 hours per staff member per week, contributing to burnout, denied claims, and longer accounts receivable (A/R) cycles. These inefficiencies ultimately result in reduced revenue and patient dissatisfaction.

Why is burnout in ABA clinicians considered a financial risk, not just an HR issue?

Burnout leads to costly turnover, lower client retention, and decreased productivity. Recruiting and replacing a BCBA or RBT can cost up to $5,000 per hire, plus months of lost revenue and disruption to morale.

What are effective strategies for improving ABA staff retention?

High-performing ABA organizations invest in clear career pathways for BCBAs and RBTs, align compensation with market benchmarks, and foster peer-led mentorship, flexible schedules, and wellness programs.

How can ABA organizations reduce the administrative burden for clinicians?

Automation tools like Plutus Health's Zeus streamline eligibility verification, denial management, and billing, reducing manual workloads by 5–10 hours weekly per clinician and improving clean claim rates by 95%.

What's the ROI of outsourcing RCM in ABA therapy organizations?

Outsourcing revenue cycle management can improve collections, reduce denials by up to 30%, and free clinicians from billing-related admin tasks, resulting in better client care and financial outcomes.

What's a proven example of operational transformation in ABA?

One $200 million ABA network partnered with Plutus Health to automate eligibility and accounts receivable (A/R) processes. The result: $2M reduction in legacy A/R and a 97% Net Collection Rate.

How can ABA organizations prepare for value-based care models?

By improving operational efficiency, investing in technology, and ensuring workforce stability, ABA leaders can align outcomes with reimbursement. Plutus Health supports this transition with scalable RCM and automation strategies.

Gett Johnson

Gett Johnson has 30+ years of experience in Healthcare I.T. and RCM Professional. His skillset includes being an expert in Healthcare I.T. software and hardware solutions. He is helping health systems, hospitals, ASCs, medical offices, and healthcare organizations become financially healthy by optimizing complete RCM processes.

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