KPI

Industry Standards:

Pre-registration & Pre-authorization

Overall pre-registration rate for scheduled patients	>95%
Overall insurance verification rate of pre-registered patients	>95%

What is your KPI(Key Performance Indicators) for the Revenue Cycle?   

1.  A/R by age Current 30, 60, 90, 120, 150 180, 210, 365? Or a combination of such?

What is the percentage to go with each of these cateogries?  That is at current do you have 45% of your outstanding balances?  Etc.

2.  Credit balances

    Hospital 1:  Our goal has been to be at $800,000 or less on a monthly target. 

3.  Bad Debt

4.  Unbilled A/R and how or the break out(inhouse, recurring, etc)

5.  Collection Agency (Early out, Bad Debt, multiple agencies) percent collected (no names of agencies please)

     Hospital 1:  Using a combination of Early out, Secondary Agency, & Tiertary Agency (which is considered to be the true bad debt agency).  With the early out vendor we are averaging 50% collection return.

6.  Electronic Claims filing percentage

     Hospital 1: Goal is to have 75% of first time claim filing pass claim edits.  Currently running at 79%.

7.  Denial Management (Percentage of gross charges being denied from payers)

8.  Charity Care/Financial Assistance

     Hospital 1:  Goal is to have a minimum of 1% of monthly gross A/R go toward Charity Care.  Currently running at an avg of 1.4%.

6.others?

For any of the categories above please be specific.  We would like to add the results to the webpage for other Revenue Cycle & Patient Account Directors, CFO's, and Controllers could use for KPI's.

No names of facilities will be added.  If you have some above average numbers we would like to know more of your story in how you were able to acheive these results.  Your formula's, process & procedures, and any other documents that will help to understand your results.

Please send your results to Shawn Steffen, Mercy Medical Center at ssteffen@mercycare.org.