Kpi webinar deck 11 2016 final

2016 Webinar Series:

5 KPI’s for Financial Success

To listen to the audio on this webinar, please click on the link below:https://healthcois.webex.com/healthcois/lsr.php?RCID=73fb0eec478d4ac1b75ede603e353351

The HealthCo Team

PanelistsKelly McAvoyImplementation Consultant

HealthCo Information Systems

Andrea CunninghamDirector of Services

HealthCo Information Systems

Larry JurgensDirector, Healthcare Consulting

Jurgens & Associates

Measurement = Success

Setting KPI’s

Select KPI’s that have a clear tie to strategic business initiatives

Ensure your team has control over the KPI’s

selected

Use simple, easy to understand KPI’s that

will make sense to your team

Make sure your KPI’s cannot be manipulated by the team…they need

to be credible

Guidelines

Measurement = Success

Days In AR AR by Day

Adjusted Collection

Rate

Schedule Maximization

Claim Denial Rate

KPI Categories

Measurement = Success

KPI Days In AR

Definition

Average number of days it takesyour clinic to get paid

Target*38 Days

Measure

Divide your current receivables, net of credits,by your average daily charge amount

*MGMA National Best Practice Standard

Poll Question

How Do We Improve?

Set your goal and measure!

Monitor claim submission timing; daily is the best practice

Identify problem carriers that take more time than your average to pay• Provide action list to staff with narrow group of high impact payers

Utilize your billing system to monitor unbilled or missing charges; visit status is one way to monitor this

Prioritize staff activity and workplans• Centricity Task Management provides a tool for this

Days In AR

Measurement = Success

KPI AR By Day

Definition

The amount of receivables viewed by daysoutstanding (0-30, 31-60, etc.)

Target*

0-30: 57% 31-60: 12%61-90: 7% 90+: 24%

Measure

Divide your current receivables in each agingbucket by total receivables and multiply by 100

*MGMA National Best Practice Standard

Poll Question

How Do We Improve?

Set your goal and measure!

Set payment plans with patients if you are unable to collect in full up front

Break out of the “statement habit” by suggesting credit card payment

Focus on carrier response to claims and if they fall outside 30 day response window

Prioritize staff work by dollar amount and aging bucket to target highest impact claims first; focus your time on your best return

Days In AR

Measurement = Success

KPI Adjusted Collection Rate

Definition% total available reimbursement collected

Target95%+

Measure

Divide payments, net of credits, by allowablecharges submitted, multiply by 100

Poll Question

How Do We Improve?

Set Goals and Measure!

Know your allowable amounts!

Challenge your payors if you see reimbursement below cost; if you don’t manage this you are at the payors mercy

Monitor your payments through reporting to show the variance between contract rates and receivables

Empower your billers to challenge a payment amount

Days In AR

Measurement = Success

KPI Schedule Maximization

Definition

% of available schedule slots filled with billablevisits

TargetInternal target required

Measure

Divide filled visit slots on schedule by totalavailable for review period (day, week, month)

*MGMA National Best Practice Standard

Poll Question

How Do We Improve?

Set Goals and Measure!

Utilize a “recall feature” to get patients back in for services that are overdue

Establish a protocol in your clinic on offering first available appointments

Use a wait list to fill in for cancelled visits

Track no-show rates and re-offenders in your clinic

Consider a cancellation/no-show policy

Days In AR

Measurement = Success

KPI Denied Claim Rate

Definition

% of claims submitted that have been denied bypayers

Target5% or less

Measure

Divide denied claims amount by totalreceivables, multiply by 100

*MGMA National Best Practice Standard

Poll Question

How Do We Improve?

Set Goals and Measure!

Understand the reasons for your denials

Track denial reasons with product like Denials IQ

Utilize claim scrubber to claims out the door clean the first time

Use the data on denials to train staff and keep from repeating the same mistakes

Enable communication between teams working denials and front end billing

KPI Tracking Poster

To request a free clinic KPI poster: http://www.healthcosystems.com/go/kpi-poster/

Resources

andreac@healthcosystems.com

l.jurgens@comcast.net

kellym@healthcosystems.com

http://www.medicalpracticeinsider.com/best-practices/keying-kpis