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6 Import Evaluation Metrics That You Should Track To Evaluate Physician Billing Services

August 24, 2020 by Jeremy Lindy

Most medical practitioners evaluate their financial health by simply analyzing the extent of cash flow.  However, physician billing services refer to the complete set of procedures that are performed from the beginning of charge capture and goes through claim submission, account receivables collections, and ends up on the final financial audit.

This procedure allows physicians to monitor all the cash points and ensure a steady revenue flow. Although, if practitioners tend to fail to track down overall physician billing services then it would make physicians lose tons of money indeliberately. Practitioners must keep track of revenue cycle by using EHR with Revenue Cycle Management in order to better control their revenue fluidity and manage their finances wisely. In this article, I have provided a quick guide that can help physicians to prepare evaluation metrics and provide insights into useful procedures that can help them to regularly check these indicators.

Monitor Gross Revenue:

Practitioners must keep the track record of gross collections and use this data to calculate the ratio for paid and unpaid claims. According to recent studies, it has been deduced that if the collection ratio is 95% then it is considered normal. On the other hand, if your practice is collecting less than 5% unpaid claims then it reflects that medical practitioners should reconsider their strategies used for medical billing services. They should strive to understand and catch the reasons behind delayed payments. Even medical billers should keep an eye on insurance payers and identify those payers who are providing reimbursements in a timely manner. Due to a certain fault in your physician billing cycle, a significant amount of revenue can slip through the cracks.

Number of Days In Account Receivables:

For this purpose, practitioners must prepare evaluation metrics to analyze the total number of days that are required by insurance companies and other payers to pay reimbursements. The number of days can be calculated by dividing the total number of account receivables with daily charges. For a healthy financial balance, more than 95% of your account receivables should be paid in less than 50 days. On the contrary, if more than 5% of your account receivables stay unpaid then you should implement improved strategies for physician billing services. 

Actually, account receivables represent how long the claims remain unpaid on average. Practitioners should keep the track record of aging account receivables annually. By measuring this metric, practitioners can analyze the amount of time required in a year to collect all the payments and identify the reasons for delayed payments.

Measure Required Months:

You should keep track record of all the payments that are collected in a month. This analysis would allow you to understand the ratio of average revenue that you could generate in a month. This monthly report, practitioners can identify the change of collection rate between two consecutive months. This monthly metric would help you to regularly estimate the consistency of physician revenue cycle management services.

Estimate Patient’s Deductibles and Copay:

Practitioners must make sure that their administration is consistently collecting maximum deductibles and co-pays in a timely manner. In this way, physicians can become assure that they are collecting 100% revenue for their services and leaving not a single dollar on the tables. For this purpose, experts of physician billing services should prepare a measuring metric every month or for 90 days to analyze the revenue collected directly from the patients.

Calculate Successful Claim Submission Rate:

If your practice is submitting 95% of the claims without any objection to the health insurance companies then your medical business is headed towards its success goals. It is essential to meet your revenue goals to submit clean claims for all of your services. Clean and accurate claims are the most integral factors of a successful medical practice. Therefore, it is important to troubleshoot problems in the claim submission process so providers can never miss their revenue targets. Practices should make sure that their administrative staff is maintaining claim denial rate less than 5% and competing ahead to meet the revenue goals.

Analyze Individual Productivity Of Physicians:

When operating under one office, then practitioners should analyze each aspect of their business. Therefore, you should prepare measurable metrics to estimate the overall productivity of healthcare practitioners. It would be really difficult to analyze actual results and judge the profitability of your practice without analyzing the overall productivity of physicians.

Conclusion:

Physicians can observe a significant improvement in their revenue collection procedure with the help of these measurable factors. An effective physician revenue cycle management system can help physicians to handle their financial data in a useful way and meet their revenue goals.

Medcare MSO is a US-based medical billing company that has been helping its clientele all around the country to increase its gross production for 12 years. Click here, to consult with the medical billing experts that can create a difference in your business performance by providing value-based services.

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August 24, 2020 /Jeremy Lindy
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