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Revenue Cycle KPIs

Revenue cycle KPIs are a set of performance metrics that enable organizations to track and measure the effectiveness of their revenue cycle management processes. These KPIs help monitor key revenue cycle processes, such as patient registration, charge capture, claims submission, payment posting, denial management, and collections. Revenue cycle management is a critical function in any organization, and measuring the efficiency and effectiveness of revenue cycle processes can help improve cash flow, reduce bad debt, and enhance patient satisfaction. The revenue cycle team’s success is measured by their ability to optimize cash flow, reduce days in accounts receivable, reduce denials, increase clean claim rates, and improve patient collections. By monitoring revenue cycle KPIs, organizations can identify areas for improvement and implement strategies to streamline their revenue cycle processes, ultimately leading to improved financial performance and operational efficiency.

Revenue Cycle KPIs Reporting Dashboard

Revenue Cycle Agent Objectives

The revenue cycle agent objectives or KPIs are designed to track and measure the revenue cycle agent’s operational efficiencies, including elements such as improving POS cash collections, reducing bad debt, reducing late payment charges, understanding payer requirements, and monitoring major payers over time.

  • Improve the Point-of-Sale (POS) cash collections – This KPI tracks and measures the extent to which the revenue cycle agent is able to improve the Point-of-Sale (POS) cash collections over time. The higher this metric, the greater the revenue cycle agent’s ability to improve the POS cash collections over time.
  • Improve the Days in total Discharged not Final Billed (DNFB) – This KPI tracks and measures the extent to which the revenue cycle agent is able to improve the Days in total Discharged, not Final Billed (DNFB) over time. The higher this metric, the greater the revenue cycle agent’s operational efficiencies in this regard.

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  • Improve (reduce) bad debt – This KPI tracks and measures the extent to which the revenue cycle agent is able to improve or reduce bad debt over time. The higher this KPI, the greater the revenue cycle agent’s ability to improve or reduce bad debt over time.
  • Improve (reduce) days in accounts receivable (A/R) – This KPI tracks and measures the revenue cycle agent’s ability to improve or reduce the days in accounts receivable (A/R) over time. The higher this metric, the greater the revenue cycle agent’s operational efficiencies in this regard.
  • Improve (reduce) late charges as a percentage of total charges – This KPI tracks and measures the extent to which the revenue cycle agent is able to improve or reduce late charges as a percentage of total charges over time. The higher this metric, the greater the revenue cycle agent’s ability to improve late charges as a percentage of total charges.
  • Review financial hardship applications – This KPI tracks and measures the revenue cycle agent’s ability to review financial hardship applications. The higher this metric, the greater the extent to which the revenue cycle agent is able to successfully review financial hardship applications.
  • Understand payer requirements and monitor major payers – This KPI tracks and measures the extent to which the revenue cycle agent is able to understand payer requirements and monitor major payers over time. The higher this metric, the greater the revenue cycle agent’s operational efficiencies in this regard.

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Revenue Cycle Team Objectives

The revenue cycle team objectives or KPIs aim to track and assess the effectiveness and efficiency of the entire revenue cycle team in achieving revenue goals. These KPIs include improving the clean claim rate, reducing the cost to collect, and increasing the net collections percentage. Additionally, KPIs may also focus on improving cash collections as a percentage of net patient revenue service, identifying areas of high denial rates, and implementing strategies to reduce such denials. Effective measurement and improvement of revenue cycle team KPIs can lead to increased financial stability and growth for the organization.

  • Improve the clean claim rate – This KPI tracks and measures the extent to which the revenue cycle team is able to improve the clean claim rate over time. The higher this metric, the greater the revenue cycle team’s ability to improve the clean claim rate over time.
  • Improve (reduce) the cost to collect – This KPI tracks and measures the extent to which the revenue cycle team is able to improve or reduce the cost to collect over time. The higher this metric, the greater the revenue cycle team’s ability to improve or reduce the cost to collect over time.

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  • Improve the resolve rate – This KPI tracks and measures the revenue cycle team’s ability to improve the resolve rate over time. The higher this metric, the greater the extent to which the revenue cycle team is able to improve the resolve rate over time.
  • Improve cash collections as a percentage of net patient revenue service – This KPI tracks and measures the extent to which the revenue cycle team is able to improve cash collections as a percentage of net patient revenue service over time. The higher this metric, the greater the revenue cycle team’s operational efficiencies in this regard.
  • Improve the net collections percentage – This KPI tracks and measures the extent to which the revenue cycle team can improve the net collections percentage over time. The higher this metric, the greater the revenue cycle team’s ability to improve the net collections percentage over time.

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Revenue Cycle Manager Objectives

The revenue cycle manager objectives or KPIs are designed to track and measure the revenue cycle manager’s operational efficiencies, including elements like implementing a system to ensure that accurate billing information is entered into the billing system and managing staff performance by providing regular feedback, performance reviews, and one-on-one meetings.

  • Implement a system to ensure that accurate billing information is entered into the billing system – This KPI tracks and measures the revenue cycle manager’s ability to implement a system to ensure that accurate billing information is entered into the billing system. The higher this metric, the greater the revenue cycle manager’s operational efficiencies in this regard.
  • Supervise the various duties of the revenue cycle department, such as account management, communications with insurance providers, collections, cash posting, contract analysis, and billing – This KPI tracks and measures the extent to which the revenue cycle manager is able to supervise the various duties of the revenue cycle department, such as account management, communications with insurance providers, collections, cash posting, contract analysis, and billing. The higher this metric, the greater the manager’s operational efficiencies.

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  • Manage staff performance by providing regular feedback, performance reviews, and one-on-one meetings – This KPI tracks and measures the extent to which the revenue cycle manager is able to manage staff performance by providing regular feedback, performance reviews, and one-on-one meetings. The higher this metric, the greater the revenue cycle manager’s operational efficiencies in this regard.
  • Oversee the hiring and training of staff – This KPI tracks and measures the extent to which the revenue cycle manager is able to oversee the hiring and training of staff over time. The higher this metric, the greater the revenue cycle manager’s ability to oversee the hiring and training of staff.
  • Efficiently manage patient complaints in respect of billing and collections – This KPI tracks and measures the extent to which the revenue cycle manager is able to efficiently manage patient complaints in respect of billing and collections over time. The higher this metric, the greater the revenue cycle manager’s operational efficiencies in this regard.
  • Plan and structure the department workflow and staffing – This KPI tracks and measures the extent to which the revenue cycle manager is able to plan and structure the department workflow and staffing over time. The higher this metric, the greater the revenue cycle manager’s ability to plan and structure the department workflow and staffing.
  • Improve (reduce) the denial rate – This KPI tracks and measures the extent to which the revenue cycle manager is able to improve or reduce the denial rate over time. The higher this metric, the greater the revenue cycle manager’s ability to improve or reduce the denial rate over time.

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These revenue cycle KPIs are an integral part of ensuring that the revenue cycle team meets its key efficiencies and critical organizational goals. The successful implementation of an effective revenue cycle strategy plays a vital role in ensuring that the company meets its operational and administrative goals. As a result, measuring these objectives is key to operational success. These KPIs focus on tracking metrics grouped in three result areas: agent, team, and manager.

It is critical to track and measure these revenue cycle KPIs over time because they offer insight into the revenue department’s successes and where improvements are needed. Metrics like improving the POS cash collections, improving the clean claim rate, reducing the cost to collect, improving the net collections percentage, and reducing the denial rate are fundamental to ensuring the company’s operational success.

Implementing revenue cycle KPIs or objectives for the revenue cycle team, agent, and manager drives the obligation to guarantee consistency over time. High-performing metrics are valued, translating into an effective revenue cycle management strategy and application thereof by the revenue cycle team, manager, and agent. On the other hand, low-performing metrics must be revisited as they show poor performance and detract from operational and organizational success metrics.

Benefits of AssessTEAM cloud-based employee evaluation form for your revenue cycle team.

  • Use on all smart devices
  • Include custom KPIs
  • Keep historic trends
  • Include eSignatures
  • 360-degree feedback
  • Unlimited customization
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