Missing H&P.No Op Notes.Late and missing charges.Need to combine accounts. There are many things that delay coding and increase DNFB. Coders want to code, and those I know are darn good at it. We measure coder “productivity,” but do we measure the barriers that get in their way? Why is it important? When we measure […]
Eligibility Verification Rate
“I don’t have time to check insurance eligibility.” “It slows down our throughput during busy times.”It does take time to ask for the insurance information and I would argue, it is as important as the health history information. If we don’t collect the insurance or correct insurance, we bill the patient and cause them undue […]
Patient Financial Journey
Pre-Service Patient Collection Rate
“I’m afraid to ask for money.”“What if they can’t/won’t pay?”“I barely have time to get them registered, now I have to ask for money too?” Thirteen years ago HDHPs were just gaining steam in the marketplace. In October 2008 I gave a conference presentation encouraging providers to start changing their patient collection practices. Frankly, the […]
The Problem I can’t pay my healthcare bill. It was not planned. I have health insurance, but my deductible is $6000 and my out of pocket max is $12,000. That bill is a lot more than I expected. The hospital calls me every other week, I don’t want to talk to them because I don’t […]
High Deductible Health Plans, coinsurance, copays, noncovered services. The list seems endless of the reasons healthcare providers have been collecting more cash from patients than from insurance plans in recent years. Why is it hard? None of us plan to get ill. Accidents happen. We find ourselves lying in the emergency room bed. After I […]
Discharged Not Final Billed are accounts stuck between the time the patient has discharged and the time a claim is generated. Activities that occur during this time include days waiting for final charges, coding and other unique reasons not to finalize for billing. One may want to break out coding days as a subset of […]
Denial Rate
We started our KPI series with A/R Days, the next one is Denial Rate. There are a couple of them, the one I’ll cover here is Remit Denial Rate. Why is it important? Denial prevention and appeals have been and continue to be one of the most resource draining activities of Revenue Cycle Management (RCM). […]
Every RCM leader knows that without a set of KPIs you are flying blind. The first of these measures is Days in Accounts Receivable. Why is it important? You have to know how fast you are turning receivables into cash. It’s a quick indicator how well accounts are moving from admission to payment. What’s the […]