5 KPIs to Help Measure Revenue Cycle Management Success

The Healthcare industry is one of those fewest industries that are always on the go, with hundreds of patients coming in and out of one of its units on a daily basis. The type of patients might differ, but they all demand care and attention and bring a continuous rolling revenue cycle. In this condition, it is absolutely necessary to manage the income of the hospitals or private clinics in such a way that it helps in running the operations smoothly. One of the ways that let the financial officers or management determine the function of the hospital and overall business are key performance indicators. KPIs bridge industry risks and regulatory requirements. RCM MATTER can help you measure Revenue Cycle Management success using these 5 KPIs:

Top 5 KPIs to help measure Revenue Cycle Management Success

Net Days In Account Receivable:

This A/R KPI helps in determining the effectiveness of the revenue cycle. By dividing accounts receivable by Average daily charges, you get the Net Days In Account Receivable. You need to evaluate the balance sheet and income statements of the hospital or clinic to derive the above numbers. The DAR will give you the average days to collect your payments.

Point-of-Service Cash Collection:

As the name suggests, this one is specifically for point-of-service efficiency. The payment is made at POS or a week after it is regulated by and impacts this KPI. This helps in determining how much POS affects the revenue management system. It is determined by dividing POS payments by self-pay cash payments.

Days in total discharged not billed:

The KPI you would need to see the total functioning and performance of your revenue cycle and factors directly associated with cash flow is Days in Total Discharged, not Billed. It is also commonly referred to as DNFB; it works on the proficiency of the claim-generation process. By dividing money in DNFB with average daily gross revenue, you can calculate Days in total discharged, not billed.

Bad Debt:

If you need a KPI for your clinic or hospital to determine how well you are collecting the dues of your patients and insurance or how well you counsel them regarding financial aspects, you can take help from Bad Debt. A high amount is never a good amount and will only increase the inadequacy of the whole operation of the healthcare organization. You can also evaluate what other KPIs you need to improve.

Clean Claim Rate:

Last but not least is the Clean Claim Rate. This KPI helps in evaluating the performance or inefficiency regarding the claims made. From the rejection of the claims to their clearance, all are regulated under this KPI, and to calculate it, you need to divide the passed or cleared claims by the total number of claims made. The longer a claim takes, the longer it takes for a payment to get cleared. Hence, this is one of the important KPIs to evaluate the organization’s efficiency.