How committed is your team to making your practice the best it can be? From your medical billing department to your clinical staff to your front desk reps, everyone involved in day-to-day business around your office should be motivated to help you become a top-of-the-line medical establishment.
But instilling a competitive instinct in your staff requires a top-down approach. If your practice management team isn’t setting goals and monitoring, measuring, and improving your overall results, you can’t expect your staffers to understand what objectives they should work toward.
One vital area of practice performance is productivity metrics. Making productivity gains requires that you pinpoint certain metrics to measure, set benchmarks, and take actions based on data - rather than just hum along at a baseline level of efficiency and output. Consider the following performance areas as you outline a productivity assessment plan.
Net Collection Rate
When thinking about your revenue, you may be inclined to focus on gross collection rate - the total of your initial charges before adjustments. But your net collection rate is a better measurement of financial performance and collections effectiveness, since it factors in the percentage (after negotiated contract write-offs) of collectible funds that are actually collected by your practice.
A net rate above 95 percent means you’re performing optimally. If you’re falling short of that, take a look at your payer contracts and consider new collections options. Working with a medical billing firm is one way you may be able to optimize your contracts to help you receive the best possible results.
Denied claims are the fastest way to put your practice at risk, since they keep you from getting paid for services already rendered. They’re also largely the most preventable, since proper ‘preventative care’ with your claims can help you dodge denials. Billers and coders can substantially reduce the chance of denials by submitting ‘clean’ claims the first time… and this is yet another way that contracting with a medical billing service can help you see better results.
Aim for a 5 percent (or lower) denial rate, and make sure you’re following up on denied claims to appeal anything you can. Otherwise, you’re leaving money on the table that’s crucial to your overall productivity.
Work Relative Value Units (WRVUs)
The most important benchmarks for measuring your physicians’ productivity are their WRVUs, the metrics designed to track the resources required by providers to perform various services. WRVUs number calculations, at large, are determined by the MGMA, assigning weight to factors like personnel time, level of skill, and sophistication of equipment required to render patient services.
WRVUs are tied directly to billing: For each service performed, a CPT code is assigned and mapped to a specific level of WRVU to be billed to the payer. For example, CPT code 99213 (a level 3 office visit for an established patient) has a WRVU of .97. Gauge your docs’ total WRVUs against the expectations in their specialty, and make sure they aim for improvement. By doing so, you’ll ensure that the responsibility for boosting office-wide performance doesn’t fall solely on your support staff!
...and if you need help with your practice revenue...