Ambulatory surgery center administrators are often asked by stakeholders to evaluate their center’s revenue cycle management (RCM) process for strengths and weaknesses. As every administrator knows, this can be easier said than done. Key Performance Indicators (KPIs) are used as a scorecard to highlight issues and determine how well an ASC is performing compared to other ASCs. For example, wild swings month-to-month in Days in Accounts Receivable Outstanding could highlight billing and collections process problems, while a high percent of AR greater than 90 days may emphasize an issue with patient collections processes and/or insurance denials.
In an effort to lighten the load for administrators, here are six KPIs to track against goals set for ourselves internally:
- Days Outstanding or Days in A/R – Regent RCM standard is less than 30 days
- Claim Lag and Charge Lag – Regent RCM standard is less than 3 days
- % of A/R Greater than 90 Days – Regent RCM standard is less than 15%
- Net Collection Rate – Regent RCM standard is greater than 97%
- Denial % and Clean Claim % – Regent RCM standard is 98% clean/less than 5% denial rate
- Business Office Staff per 1,000 Cases – Regent RCM standard is 1.5 FTEs per 1,000 cases
“A number of our clients sought our services after an internal KPI audit identified gaps and weaknesses in their RCM process,” stated Vice President Michael Orseno. “We understand the intricacies of the ASC revenue cycle, where problems commonly occur and how to fix them, as well as how to optimize reimbursement. Measurement and reporting will always be key to helping our clients achieve success.”
Over the coming weeks we will break down each of these metrics, explain how we set our internal standards, and share with you common issues and how to overcome them.
If your KPI audit reveals more weaknesses than strengths, Regent RCM can perform a free business audit. To schedule an audit or learn more call 312-882-7228.