Increase Reimbursement By Measurement

Measure Everything

Peter Drucker, a business management philosopher, coined a phrase “if you can’t measure it, you can’t manage it.” This is true on many levels but it is not the “end all be all.” However, in the revenue cycle management space, it is. If you are not measuring an individual’s productivity in data entry, how do you know if that individual is capable of doing more or should be doing less because their work is resulting in numerous denials on the back end?

Don’t Leave Money on the Table
If you do not have a quantitative benchmark established for every position or function related to your revenue cycle process, I can guarantee you are leaving money on the table. You should be able to establish a specific benchmark for each function that is not a range of numbers. Range benchmarks are a lot like averages. They provide cover for those who may be gaming the system. While averages are useful for many things, when trying to increase reimbursement within your revenue cycle portfolio, exact numbers are imperative. It is the difference between good and great.

Creating Benchmarks
If you do not have exact benchmarks created yet and are unsure of how to begin, start by doing a two week analysis on each function. Go old school. Get a pencil and paper and begin plotting daily totals. After two weeks, take the average and viola! you have a number. Begin with that number and start refining it over the next several weeks and months as you begin to get more data regarding quality. Within six months you will have an exact number to which you can holding individuals accountable.

Best Practices
I am often asked about best practices when you establish a number. While I pay attention to best practices in the industry when the information is available, that is all I do – “pay attention.” While that may sound arrogant or facetious, it is not meant to be. Only YOU as a revenue cycle manager know and understand the capability of your team. I have learned in the past 20 years that when you begin to measure and hold individuals and functions accountable, you will see increased productivity and quality. Best practices are good as a gauge to understand where your benchmarks fall within the industry norm; however, be careful. Some ratios out there as best practices will actually impede increasing your reimbursement, such as the ratio of FTE to number of patients. This ratio needs to be further explored by industry experts since, in my opinion, it is a flawed number that executives are using to benchmark their revenue cycle departments and it is impeding the growth in their revenue per transport.

Quantitative measurements first – then followed by qualitative measurements.

Please note: I reserve the right to delete comments that are offensive or off-topic.

Leave a Reply

Your email address will not be published. Required fields are marked *