Bill Sample / December 9, 2018 / Rosalie Cain
Useful metrics must be comprehensive and simple. They must combine both complete end-to-end processes and their individual components. Metrics must be used consistently over time and compared to standards. Obviously different standards apply to different medical specialties patient demographics payers and samples of CPT codes. Medical billing metrics typically include compliance cash balances charges accounts receivable and collection ratios to help monitor cash flow. This article focuses on performance metrics. For discussion of compliance program see companion article on Medical Billing Compliance. Collection Ratios Traditional metrics include gross and net collection ratios. Both metrics are subjective to individual practice because they compare (often arbitrary) charges to (allowed) payments.
Billing performance measurement is an integral part of medical practice billing process and a prerequisite to effective practice management. Systematic measurement becomes mission-critical with growth of billing complexity or outsourcing of the billing function. Traditional billing metrics are limited in scope and focus on claim submission process ignoring process imperfections on the insurance (payer) side. Modern computer technologies allow both productive measurement and effective action by the disciplined billing office to improve claim submission and payment processes. Using appropriate metrics helps improve policies and procedures shorten revenue cycle reduce patient complaints improve financial performance and compliance increase cash flow reduce bad debt identify areas of potential growth improve employee morale increase productivity and reduce costs.
When the doctor has signed a contract that says that he will designate a person responsible for that purpose you can nicely inform the person responsible for getting you the eobs that this is such an important issue to you that it is written into the contract that the doctor signed that you are to be provided with the eobs. You can also include a provision in the contract to specify what you can do if the provider is not providing you with the eobs. Another important example is an issue you will undoubtedly run into - your payment. Many people who start this business are used to receiving a regular paycheck. When you make the move to being an entrepreneur and owning your own business you can only write yourself a paycheck if your providers pay you.