Metrics to use to evaluate performance of your front office, back office and clinical staff employees.
This includes copays, co-insurance, and deductibles. You will need to know which patients owe what, and if that was collected on.
This could be zero patient complaints and/or the front office going above and beyond to help a patient; even if its opening a door for them. Being able to walk into work and bring a positive attitude is key in this position.
If you have someone verifying insurances, how quickly are they getting those done? Are they completed prior to the patients arrival?
Your First Pass Recovery Rate reflects how clean your claims go out. This is a reflection of data entry, and accurate patient information, including ID number, date of birth, and subscriber; all critical when billing payers.
A majority (85 percent or more) should be landing in this category. This metric is a true reflection of your claims going out accurately. If your 0-60 days is less than 85 percent, you have claims aging out that are either not being followed up on, or the incorrect information is not being fixed properly. There are also those very slow payers, but you should be able to look at your payer mix and decide what is going on with the older claims.
Are you getting a weekly deposit completed, and a specific amount posted each week? By challenging your payment poster, this can easily jump your revenue up a few notches with little effort.
Oftentimes, specific insurance plans will pay for some codes and not others. Knowing what codes to use and billing for the entire visit is key. Some practitioners will think, "Well, they have a deductible to meet and I don't want to over tax their budget," leaving your business to take the hit.
With the unending decline in reimbursements across the board, one area that practice owners have to implement is increasing their patient load. Although certainly not ideal, it has come to this. If you have a healthcare staff member that constantly runs late on visits, or will only see one patient per hour, then your practice will certainly suffer.
Contributions to the overall work flow and process is also a great area to measure and provide incentives. If you consistently have a member of the staff that is always looking for ways to improve your business, by all means listen. If an idea sounds like a great one, work with the staff member to implement it. They will feel empowered and will constantly work with you to improve your bottom line.