Cycle crm for healthcare

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So, there are a lot of KPIs that you want to track with your revenue cycle process and we'll go through some of the highlights. Charge lag - how many days does it take you to submit a claim? 1-5 days is really considered the industry standard. People we talk to, the places I've been --- 1-5 days is acceptable. Anything that's 6-10 days, maybe that's the average and over that you're really getting into the risk zone. Days in A/R. This is also known at some companies as DSO. This is a different metric. This is the number of days from the date of service to the payment date. How many days from that encounter are you waiting to get your paycheck? 35 days is the goal. You can be really aggressive with anything from 30-34. Anything 45 or higher is more of a risk and you really need to dig in and see if it's taking you longer to get your charges out the door (charge lag) or is a payer just by process taking a while. Clean claims rate. So you want your clean claims to be a really big metric. 95% or above is a great goal. You want to put your resources on the front end to make sure you have every check and balance as you can that a clean claim is going to the payer for reimbursement. You don't want to have to work this stuff on the back end. You want to put your work on the front end. A/R. Let's talk about A/R. We age it in 30-day buckets. Anything over 90 days aged from the date of service, you want that to be less than 10%. So, 10% 90 days and over, there are some things out there that take time to work, maybe you're waiting on an addendum with medical records, but you want to keep that A/R at 90 days or below. Rejection rate and denial rate - those are just two ways a claim can get hung up and start hanging out on your A/R for an extended period of time. So, you want you rejection rate to be less than 10%, meaning that you attempted to submit a claim but you didn't get it there to the payer. So you want to make sure again you're going back to that clean claims rate and measuring to make sure you have checks and balances on the front end. This may be with your type of software, this may be people looking at the process to make sure you're not missing anything. Cash collection. So, 90-plus percent. Across the industry, anything from 85% to 96% are the common numbers we hear. 90-plus percent, I would have a goal of 95%. That to me is aggressive but it makes sure you're getting that cash back in the door, especially with those in-network payers where you have a contract and you know what you should be paid. Bad debt. This can be measured a lot of ways. The metric gauges the amount of non-contractual charges, things that are a write-off. You really want to limit this. You don't want to work for free. You want this to be less than 5% if at all possible.