Key Revenue Cycle Management Metrics to Look For

Revenue cycle management for medical practices is an end-to-end process that includes charge capture, submission of claims, accounts receivable, and collections from payers. Similarly, considering the RCM cycle a representation of cash flow is only one part of it. Medical practices need to realize that cash flow consistency is only one aspect of the revenue cycle and a holistic approach can optimize it. In addition, revenue streams should have a consistent flow in order to keep the bottom line intact. As a result, healthcare practices stay profitable and maximize their revenue potential.

Not knowing the key metrics of the RCM process leads to potential revenue losses and leave money on the table. So, tracking the appropriate metrics that directly affect the financial health of medical practices is must. These metrics are the key performance indicators of the revenue cycle management and allows providers to improve practice profitability.

Keep an Eye on Overall Collections
Healthcare providers must be aware of the overall collections from insurance payers. It helps to stay updated with the paid and unpaid claims. Similarly, it shows how much payers owe you and what measures you need to establish. Likewise, the statistics show medical practices which insurance company is rejecting the claims. As a result, providers are able to determine ways of improving the revenue cycle process. In this way, you can maintain a steady revenue stream for your healthcare business.

Accounts Receivable Days
This metric shows how many days an insurance company takes to reimburse your claims. This is the amount an insurance company owes to healthcare provider. So, lesser days in accounts receivable should be the desired target of medical practices. If the accounts receivable is greater than 5%, you need to improve it. Similarly, aging AR shows that how much time on average the claims remain unpaid. So, healthcare providers must focus on pending accounts receivable and devise a mechanism of denial management. As a result, it enhances the revenue cycle and keeps the cash flow intact.

Monthly Revenue Goals
The goals should be time-bound to determine what you achieved in the defined timeline. Likewise, setting monthly revenue goals allow healthcare providers to know what amount of money they got from the payers. Similarly, if you hire a medical billing company to outsource revenue cycle management, ask the billing vendor to share monthly reports. MediRCM shares monthly reports to healthcare practices as it enables them to keep an eye on monthly collections.

Deductibles and Copays
There are various models of patients’ insurance coverage. For instance, co-pay model suggests that some amount of money will be paid by the insurance company and the rest by the patient. So, keeping all the patients’ data streamlined helps medical practices track the payments. The practice staff should know which amount payers owe and which amount to take from patients. As a result, it makes the payment mechanism swift and optimizes the revenue cycle management process.

Seamless Claim Submission Process
If the claim submission process of a medical practice is flawless, the claim submission rate increases automatically. As a result, the chances of claim denials significantly reduce and it maximizes overall practice collections. So, make sure the claim submission process is efficient and clean. Every practice needs to develop a smooth revenue cycle process and it helps you achieve desired targets. Consequently, the rate of claim denials reduces and medical practices optimize the financial health.

Productivity of Providers and Practice Staff
Productive teams bring great results in terms of revenue and overall performance of a medical practice. In addition, individual performance of provider and collective performance of the practice staff collectively optimize the workflows. The clear picture of the financial cycle depends on the team performance. If the revenue cycle process is high-performing, the providers and staff can focus on the patient care. As a result, the patient health outcomes improve and it increases the patient satisfaction. So, consistent cash flow and effective patient care make the medical practices profitable and productive.

The Takeaway
Revenue cycle management metrics allow physicians to streamline the practice workflows and enhance the financial well-being. Moreover, it enables healthcare providers to determine ways of improvement and make the overall process efficient. Further, it increases the overall collections from payers and patients. So, physicians should know which metrics to focus on like accounts receivable and copays. Eventually, it helps to succeed financially and make the team productive.