Part 2 – Practice Key Performance Indicators – BILLING AND RCM

By Chandresh J. Shah

Growing a practice can take a lot of work and having goals can help. That is why it is important to have KPIs(Key Performance Indicators) that can be used to determine how well practice goals are being met.

Let me share to you KPIs that will help your practice on 4 main areas:

  1. Front Desk 
  2. Clinical
  3. Billing and Revenue Cycle Management
  4. Reputation Management

Let me begin with KPI’s for Billing and Revenue Cycle Management as they are the first point of contact and impression your practice makes with existing and new patients. These KPIs are:

14. Net Collections Rate

15. Total Operating Margin

16. Average Insurance Claim Processing time & cost

17. Average cost per patient

18. Claims Rejection rate

19. Average insurance claim processing time and cost

20. Average Treatment Charge

21. Percentage of Patients without Medical Insurance

22. Time Gap between Date of Service and Date Billed

23. Percentage of Claims Denied overall, and by Payer

24. Percentage of Claims Denied due to Front-end errors vs Coding oversights

25. Percentage of Patients with Public vs Private Insurance

26. Percentage of No-Response claims overall, by Payer

In the video below, I went through and explained what each KPI meant for the Billing and RCM. You can also download the guide through this link (Click Here):