Internal Performance Monitoring Is the Secret to Medical Billing Client Retention

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Medical Billing

Key performance indicators (KPIs) are an essential component in managing the operation and profitability of our businesses, as many of us who work in the healthcare revenue cycle are aware. Organizations that simply concentrate on the statistics provided to clients (such as days in arrears and collection rates) might not be performing at their best. A shift in the internalized performance attitude results in better management, which is reflected in the outcomes for the clients.

External KPIs against internal KPIs

Internal KPIs are the objectives and standards that we uphold at the level of each individual business. These are the analytics and statistics we employ to guarantee that our internal procedures are effective and that we are providing the greatest service to our customers. These statistics and data points we provide to our clients are known as external KPIs. Internal and external KPIs naturally overlap, and we have discovered that continual monitoring of our internal KPIs frequently reveals issues before they have an impact on our clients and show up in external KPIs. Here are some internal KPIs that we have discovered to be helpful:

Aims for staff productivity

The most effective medical billing companies regularly assess their claims workload and validate daily productivity goals. The volume of claim creation, the amount or number of payments deposited, and the frequency of rejection corrections are some common metrics to keep an eye on. We advise comparing these internal KPIs to client-facing KPIs like days in account receivable, denial rates, and clearinghouse rejections on a monthly basis. This comparative procedure enables your business to “keep ahead” of problems before they have an impact on your clients’ revenue flow.

Days from receipt of data to the filing of claims

If you are not currently doing so, we strongly advise that you start. The quickest approach to identify problems with the flow of claim information to your organization is to look at the number of days from data receipt to claim submission. Keep your clients informed about patient flow and ask them to let you know if something out of the ordinary happens, such as a location closing or office hours being extended on specific days. You may then monitor the claims flow and get a general notion of how many claims are generated each day. You are only a few days away from the problem’s start if there is a rapid decline in claims or an unexpected surge, which should make finding the problem simpler. Checking in with the managers of different departments, such as IT for file transfers, coding for claims flow problems, and front-end submission for clearinghouse problems will frequently assist identify the issue fast.

Client Information

In order to maintain the service levels—which are essential for attracting new customers—we also advise you to monitor client satisfaction internally. Making two spreadsheets is a helpful method for accomplishing this. The first spreadsheet is used to keep track of internal problems that could perhaps influence reimbursement. It’s amazing how quickly we forget the specifics of anomalies, so make sure to record the event along with some supporting data, such as if there was a problem with file transfers and claims weren’t issued for a day or two. This operational performance history can be periodically examined and used to inform future process improvement. Make another spreadsheet to compile notes from client meetings and phone calls. If your business does not routinely forward meeting minutes, you might want to consider adopting this practice. Create columns on the sheet for issues with payers, complaints made about your team in meetings and over the phone, client changes that will reflect reimbursement, and anything else you feel is important. A spreadsheet makes it simple to track conferences and calls over time, which enables the identification and proactive management of reoccurring client concerns. On the other hand, they can also be helpful when clients have received advice but, for whatever reason, have chosen not to heed it, causing a disruption in cash flow. The secret to building strong, long-lasting relationships with your clients is to establish both internal and external goals for performance. The above-mentioned constant monitoring will keep you ahead of operational concerns, giving you the best chance to keep (and win over) customers.

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