The physician group we partnered with needed a way to increase transparency into their revenue cycle metrics and better understand potential bottlenecks creating delays in their billing cycle. They needed to overcome hurdles in requesting data and resources from internal teams to help them identify and monitor key performance indicators (KPIs) to effectively and efficiently communicate process and problems between management and leadership.
Our team of revenue cycle experts were tasked with:
- Consolidating and refining the goals presented by their leadership and management groups and translating the goals into measurable KPIs
- Centralizing and standardizing KPI definition
- Aggregating data
- Designing data drilldown paths
- Defining benchmarks and thresholds for alerts
We created an application that monitored revenue through its various stages in the billing process, from initial posting, through coding review, and on to billing and collections. We designed the application to allow the user to identify trends within their revenue capture and collections at the physician, department, bill area, financial class, payor, and provider level, and to identify bottlenecks where revenue was being held in a coding review workqueue.
- Centrally agreed upon metrics and a scoreboard
- Access to integrated data previously not available
- Indicators to potential system, resource or payor problems
- Proactively alerted managers of issues in their billing cycle
The application allowed users to drill into bottlenecks within their revenue capture process and they were able to identify over $2 million being held in a workqueue for a single physician and bill area. By allocating staff to work with this physician to improve their charge capture process, they were able to fix the issue causing revenue to be held and reduce the lag time to submit claims for that physician. This lead to a faster billing cycle and increased collections for the organization.