The revenue cycle is the life blood of a medical practice. Claims go out, hopefully with few errors, and payers reimburse those claims quickly. But because there are so many claims going to so many different payers, it can be hard to keep track of them and all and make sure you’re reimbursed properly. In two part blog series, we discuss the reports that should be ran to help you achieve Gold Standard Billing.

First Pass Payments {Bi-weekly}:
This report indicates how many claims are submitted accurately the first time. This report is the core metric driving overall performance. We recommend aiming for 90% success on first pass claims.

Amount Collected after 120 Days {Bi-weekly}:
Run a report that analyzes how many claims are not paid after 120 days. We suggest working to minimize this amount of claims to less than 5%.

Average Days in AR (Bi-weekly}:
This report gives you a feel for the velocity of your revenue cycle. The shorter the amount of time from claim initiation to zero balance, the better your revenue cycle. Aim for an average 30 days in AR.

Time to Payer {Two Business Days}:
Another key factor in your revenue cycle is how quickly claims are submitted for reimbursement. The ideal goal is for claims to be submitted to payers within two business days of provider signing.

Rejected Claims {Two Business Days}:
Run a report that compares when rejection notices come in and how quickly the claim is resubmitted for payment. An ideal process will have rejections resolved and resubmitted for payment within 48 hours.

If you’re not sure how to run these reports in your EMR/PM or clearinghouse website, talk to your vendor directly. And keep your eyes out for the second part of this series!