Are You Paying Close Attention To These Physician Billing KPIs?

Article Highlights

  • Physicians are working through financial stress running their practice.
  • Build out your physician billing KPIs to monitor the health of the practice.
  • Outsource medical billing to PMB to collect all revenue you are entitled to.

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Physicians across the U.S. have dealt with a tremendous amount of upheaval since the pandemic. Changes in health protocols, the expansion of telehealth services, interference from insurance companies, and trying to re-engage patients have created a unique set of challenges for physicians.

While these are all important issues to work through, it’s easy to lose sight of the financial performance of your practice. In fact, physicians that don’t pay attention to the performance of their practice often create more stress for themselves.

According to Medscape’s National Physician Burnout & Suicide Report 2021, avoiding financial stress is the #1 answer that physicians provided when asked what would help them reduce burnout.

Of course, when you’re working throughout the week, plus weekends and holidays, it can be difficult to find the time to focus on billings and other financial-related issues that affect the health of your practice.

Bottom line: Consider some of the most important physician billing KPIs (Key Performance Indicators) that you need to pay attention to. When you take the time to look at these KPIs, then you can identify financial and operational problems that need to be dealt with to support the health of your practice — and your personal health.

Physician Billing KPIs to Look For in the Pandemic Era

You should have a dashboard of physician billing KPIs that you periodically review and use to ask questions. Use these KPIs to get to the bottom of your billings so that you drive toward collecting all of the revenue that your practice is entitled to.

Cost Per Encounter. If you are not collecting revenue on each patient visit, then your costs to provide care will outpace revenue collected. This will quickly add up where your practice is no longer profitable, creating financial stress. Make sure revenue is staying ahead of costs so that you can retain profitability.

Accounts Receivable. How long are you waiting to receive payment for the services provided to each patient? Track your A/R by 30 days, 60 days, 90 days, and 120 days to determine whether your practice is on schedule or if your receivables are lagging behind the expected receipt of payment.

Total Revenue by month/quarter/year. Break out your total revenue figure by periods so that you can look at immediate revenue collections versus longer-term trends. Perhaps there is seasonality to your practice where you see more patients or provide higher-revenue services during certain times of the year. Track this so that you can identify any dips that you should be concerned about. Then, if there is a dip, you can ask questions and look into why you’re not collecting as much revenue as in previous periods).

Claim Denials Per Patient. If you are seeing a rise in the rate of claims being denied by insurance companies and other providers, then you need to ask questions about what’s going on. Are your billings inaccurate or incomplete? Is your office staff not responsive to questions about the services provided to patients? Is your staff handling too many other tasks and losing visibility into billings? Use the KPIs to work towards improvements in claim denial management.

Activity By Payer. It’s critical to pay attention to all activity by payer to notice trends for each source. Are you experiencing problems with Medicare or one of the major insurance providers? Set up individual tracking for each payer so that you can observe trends and ask questions about problems. Then, your office can take corrective action to loosen up bottlenecks and start receiving payment for services.

Current Cash Flow. How much is coming in versus going out of the practice? Make sure you are actively analyzing whether enough income is coming into the practice to offset any costs that your practice incurs. If you are looking to grow the practice by investing in new equipment or adding more rooms, you need to make sure you have enough coming in to cover the additional costs.

Find Support With Medical Billing for Your Practice

Once you start to utilize these KPIs to track and monitor the performance of your practice, you may come to the realization that your practice needs support with medical billings.

Not every office is set up to handle billings as best as possible. And, that’s okay. Our team at Precision Medical Billing (PMB) can step in to provide support so that you can achieve the financial goals of your practice. We have a 98% claim acceptance rate and we increase revenue for 100% of the clients that we serve!

We will ensure that you receive payment through our outsourced medical billing service. We are large enough to provide a dedicated medical billing expert for each payer that you deal with. We specialize our focus by payer mix so that we can help you address the unique billing challenges for each payer to help optimize revenue collections.

Schedule a consultation with our team to discuss the physician billing KPIs we identified in this article and outsourcing medical billing to our team. We have a solution that will work for your practice so that you can spend more time focusing on the health of your practice and taking care of yourself.