Wednesday 18 September 2024

Are You Measuring the Right Metrics in Nursing Home Billing?

Looking to tune up revenue for your nursing home? Focusing on collections, managing denials, and increasing clean claim rates are good places to start.   


 


Also, investigate the key performance indicators of your practice to have a vivid idea about the financial and functional performance of your nursing home.   

 

In this blog, we have discussed the most important key performance indicators in nursing home billing to help you with finding the best possible strategy to optimize your practice’s revenue.  


KPIs in Nursing Home Billing

 

1. Days in AR: Days in the accounts receivable bucket is a significant indicator of your nursing home billing performance. The higher the number of the turnaround time of your reimbursements, the more concerning it is.   

 

Usually, the turnaround time of a reimbursement should be 33 days. An AR bucket older than 45 days is a warning sign for your nursing home facility. It is time you should rethink your revenue cycle management strategy.   

 

2. Clean claim ratio (CCR): The percentage of clean claims, or claims paid at first submission, is known as the first-pass ratio. A clean claim is one that has never been denied, has never had an avoidable denial, has never been submitted more than once, and is error-free.   

 

You should determine your claim handling ratio (CCR), estimate the time required to rework rejected claims and identify the reasons behind claim denials because clean claims result in faster payment. The CCR for most procedures is between 70% and 85%. If your CCR is more than 90% or 95%, your RCM plan is working.  

 

3. Net collection ratio: It is the portion of the total reimbursement that has been collected that has been allotted. This measure is the ultimate gauge of successful collections since it shows how efficiently the revenue cycle operates.   

 

Net collections, as opposed to gross charges, show what your practice might reasonably anticipate receiving back in reimbursement. It illustrates how revenue is impacted by denial rates, unpaid visits, and other variables.

 Nursing home billing and coding is an intricate process, and a minor mistake can lead you to claim denials and revenue leakage.   

 

By measuring these metrics, you can gain insight into your practice’s revenue cycle management and identify the loopholes within the same.   

 

However, as easy as it sounds, identifying and analyzing the metrics of your practice demands a significant amount of time and other resources.   

 

Expert help is a better choice!  


Sunknowledge-Your Trusted Partner in Nursing Home Billing  

As the industry is evolving, more providers and healthcare facilities are turning to reliable outsourced partners who can eliminate all the challenges in revenue cycle management.   

 

Sunknowledge Services Inc., with its versatility and team of experts, has been providing revenue cycle management solutions to providers across the country.   

 

With the industry's best practices and cutting-edge technology of Sunknowledge you will never bleed revenue again!  

 

Their real-time, dedicated experts work consistently as an extension of your facility’s operations. From patient scheduling to payment collection and posting, they can provide you with an end-to-end service.   

 

A genuine RCM partner like Sunknowledge, not only boosts the efficiency and productivity of your practice but also sustains your practice’s financial and functional well-being of your facility.   


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