It is essential as healthcare practice owners that you are monitoring your billing goals to ensure that your practice is healthy and thriving.
Here are three billing benchmarks that LRS recommends being aware of at all times:
Denial/First Pass Payment Rates
How many denials are you receiving and how many claims are paid on the first try? Many factors go into these metrics including how accurate your insurance verifications are, how clean your claims are, and how timely your claims are submitted. A very efficient practice will have a denial rate under 5% and a first pass claim rate higher than 95%.
Percentage of Receivables over 120 Days
How quickly are you collecting the money you are owed? You should be aiming for less than 10% in this aging bucket. There are always going to be issues with specific claims but a healthy practice has at least 75% of their AR in under 60-days outstanding.
Payer Mix/Expected Revenue per Payer per Visit
Who are your top 5-10 payers? What are they paying you per visit? Your reimbursement rate is only as good as the payer mix of patients that you see.Maybe it is time to try to renegotiate contracts or consider going out-of-network with some insurances. LRS also recommends knowing what you are being paid per CPT code per payer per visit.
These are only a few of the KPI metrics you should be reviewing on a monthly basis. Do you see room for improvement in your practice? Contact us today at inquiries@lincolnrs.com to see how we can help you improve these essential benchmarks.