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Improving Revenue Cycle Performance: Revenue Cycle Assessment ­ Sample Deliverable

Key Performance Indicators

Indicator

Gross A/R Days

KPI Target

55 Days

Sample Hospital

65 Days

Cash Receipts as % of Net Revenue

A/R Over 90 Days

LE MP SA

100%

87%

15% - 20%

23%

Discharged-Not-Final-Billed (DNFB)

(Gross Days in DNFB includes 2-day system-billhold)

7 Days

9.9 Days

Point-of-Service Collections as % of Net Revenue

2%

0.75%

Denials as a % of Gross Revenue

1% - 2%

1.75%

Bad Debt as a % of Gross Revenue

3%

2.5 %

KPI Target Source: HFMA, H.A.R.A., and Internal Benchmarking data

© 2007 Computer Sciences Corporation

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Financial Benefits

Opportunity Areas Potential Improvement Opportunity

Reduce Discharged-Not-Final-Billed Reduce Outstanding Claims Accelerate Cash Reduce A/R over 90 Days

Balance Sheet Benefit $10.7M - $18.2M (gross) or $4.1M - $6.9M (net) = 5 - 10 Days A/R Reduction

LE MP SA

Increase Point-of-Service Collections Reduce Denials Reduce Bad Debt

Income Statement Benefit $2.1M - $3.6M (net) = Annual Recurring Benefit

TOTAL Project Benefit

$6.2M - $10.5M (net)

© 2007 Computer Sciences Corporation

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Patient Access Best Practices to Achieve

Indicator KPI Target Sample Hospital

Pre-registration rate for scheduled high-dollar services

95%

77%

Verify majority of payors via integrated electronic Eligibility System

YES

NO

Obtain required ABNs using automated medical necessity system prior to service

100%

100%

Registration data accuracy rate

Utilize dedicated Financial Counseling function

LE MP SA

98%

85%

YES

YES

Scan insurance cards, photo ID, and other patient documents

YES

NO

KPI Target Source: HFMA, H.A.R.A., and Internal Benchmarking data

© 2007 Computer Sciences Corporation

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Health Information Management Best Practices

Indicator

KPI Target

Sample Hospital

Discharged-Not-Final-Billed Gross A/R Days (post 2-day billhold)

1.5 Days

4.7 Days

IP charts coded per coder/per day

23 - 26

29

OP testing charts coded per coder per/day

OBS & AMS charts coded per coder/per day

LE MP SA

150 - 230

192

36 - 40

37

ER charts coded/per coder per day

190 - 250

178

MPI duplicates as a % of total MPI entries

0.5%

2.2%

KPI Target Source: HFMA, H.A.R.A., and Internal Benchmarking data

© 2007 Computer Sciences Corporation

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Patient Financial Services Best Practices to Achieve

Indicator KPI Target Sample Hospital

Initial clean claim submission rate

90% - 95%

91%

% of claims manually reviewed before submission?

20%

80%

Billing backlog/ Discharged-Not-Final-Billed

1 Day

2.4Days

Insurance A/R over 90 days from discharge

Insurance A/R over 180 days from discharge

LE MP SA

15% - 20%

26%

5%

7.5%

% of cash payments posted electronically

70% - 80%

45%

Dedicated team to follow-up on denials and underpayments?

YES

YES

KPI Target Source: HFMA, H.A.R.A., and Internal Benchmarking data

© 2007 Computer Sciences Corporation 6

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Information

Microsoft PowerPoint - Sample Assessment - Revenue Cycle v3.ppt

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