Monitor and Keep Track of Payer and Patient Collections

Key performance indicators are metrics that help leaders and decision makers of the healthcare industry evaluate their organization’s performance and financial health. There are many metrics to look at for analyzing various departments of a healthcare organization but there are some key metrics or performance indicators that industry leaders use for evaluation. This blog aims to look at five such KPIs.

Key financial indicators help CFOs to compare their healthcare organization’s performance to other such organizations. ‘To effectively track healthcare revenue cycle performance, healthcare organizations should develop key performance indicators (KPIs)’, advises Sandra Wolf skill, Director of Healthcare Finance Policy and Revenue Cycle MAP at the Healthcare Financial Management Association (HFMA).She mentions in her article that some of the high-performing organizations have net days in AR between 28 and 36 days, whereas net days in A/R of 50 was considered a great number.

1. Days Cash On Hand

2. Operating margin or operating profit margin percentage

3. Net days in Accounts Receivable

4. Cash Collection as a percentage of net patient services revenue

5. Claims denial rate

Read More Information Click Here 

Help the CFO Keep Track of the Healthcare Organizations Performance Blogs

10 Proven Strategies For Hospital CFOs To Increase Revenue Cycle And Operational Efficiency

 Hospital CFOs Struggle to Keep Up With the Time

Here’s what 2016 taught healthcare CFOs and revenue cycle directors about RCM and compliance auditing

 12 Models Physicians are Practicing For 2016 [Infographic]

6 tactics to succeed for ACO readiness [Infographic]

Healthcare CFOs: Evolving roles and responsibilities

ACO’s – A Step Towards A Healthy World!!!

Medicare, The White Elephant We Cannot Get Rid Of

INFOGRAPHICS: Deloitte 2013 Survey Throws Light on Physician Beliefs

Improve Profitability and Reduce Cost-To-Collect

Healthcare organizations have many functional areas to work upon, but the
two main areas that affect the hospital’s sustenance are billing and
collections. Billing influences a hospital’s revenue for the future and
collections impact the financial health of the organization.

There are some aspects of healthcare financial management if reworked and technologically updated, it can multiply the prospects of success in billing
and collections.

An article on Becker’s Hospital Review discusses how a six-hospital health system that serves more than 2 million patients per year uses a customizable
online financial engagement platform to evaluate billing process issues
and find solutions for the same.

This financial engagement platform is one of the hundreds of products
 available that help hospitals prevent billing and/or collection bottlenecks.

Billing and collection bottlenecks:

Information Technology

Operational budgeting or forecasting

Streamlining patient access functions

Improving physician productivity

Implementing a collections module

Outdated fee schedule

Coding audits

Achieving economies of scale by externalizing RCM functions

Billing vendors not meeting the SLAs

Losing the common thread with RCM vendors

1. Information Technology (IT)

Information technology has been enabling healthcare organizations to
restructure staffing models, speed up billing process, increase collections
and also communicate with patients quickly and efficiently.
IT has been indirectly responsible for securing steady and good inflow of
revenues. Using a good billing software or a collections module or
an EHR that has some part of the billing process integrated into
 it can increase the efficiency of billing cycles. Read More

RCM solutions for hospitals and small practices

Hospitals and small medical practices have never been under such intense pressure to reduce operational costs and improve the quality of patient care. In their desperate attempt to roll with the punches there’s one option that has proved to be cost-efficient and reliable time and again- outsourcing.

BlackBook , in  a recent survey, revealed that a majority of hospitals and small medical practices are turning to RCM technology vendors and revenue cycle management companies to help them handle the financial and operational blank walls facing them . Here is an infographic of it. Read More: https://goo.gl/aWtQTD

MACRA challenges for physician practices

71% of specialty physicians feel they have a long way to go to reach MACRA objectives. Shocking? This infographic based on a recent survey reveals how medical practices are struggling to meet MACRA guidelines.

Has MACRA sent your healthcare organization into sticker shock? You are not alone. The latest reform has left medical practices across the country feeling underprepared, confused and vulnerable to penalties. As sweeping changes transform the healthcare landscape it is an everyday struggle for healthcare practitioners to unbox MACRA and change their workflows and data capture processes to ensure a stress-free 2018.

Check out this blog

Tips for MACRA preparation from Experts

Like the iconic folk anthem “The Times They Are-a-Changin’, one of Rolling Stone’s greatest hits, the healthcare industry is going through seismic change. The slant is on quality patient care and pristine documentation. On compliance and raising the bar. The dizzyingly long and complex MACRA rules have forced healthcare providers to pause and reimagine their existing processes.

Here is a quick round-up of the #1 tips shared by healthcare experts. Well, when in doubt turn to the experts.

Webinar on Risk Adjustment and RADV Audits

A sneak peak of what’s in the presentation:

Ø  Information on CMS’s Hierarchical Condition Categories

Ø  HCC payment methodologies

Ø  Documentation best practices

Ø  Top 10 RADV red flags

Ø  RADV medical record checklist

Ø  Practice reminders

Ø  Top 10 documentation issues

HCC medical coding tips for practices

It’s Third Quarter of 2017 and the Medicare Advantage (MA), Plans are ramped up and ready to begin a third set of “HCC Sweeps”, for the year.  The beginning of each “sweep” period, by United, Humana, Freedom, Aetna and all the other players in the pond, should start with ensuring they have Certified Remote HCC (CRC – Certified Risk Adjustment Coders), coders in-house or remotely employed and this year, leave the novices at Risk Adjustment Coding, to train for the following year, instead of onboarding them now.  In light of recent DOJ developments.

The recent allegations by the Department of Justice (DOJ) are significant, the DOJ has made has alleged, based on audit results, that some MA Plans have been involved with upcoding of diagnoses codes that exaggerated the severity of illness of some members. This led to much higher weighted HCCs and in turn more money from CMS to the plan, for that member annually.  Please click on the following links for further information:
https://goo.gl/odsg8n