Identifying data that takes a toll on payments and denials should be a top priority for revenue cycle leaders.
Karen England, Ingenious Med Revenue Cycle Consultant: In order to track those trends and outliers and achieve success as revenue business intelligence, keep these key elements in mind:
• First, all data should be as close to real time as possible. Having immediate access to data and being able to respond to opportunities and issues as they arise is huge.
• Second, ensure your business intelligence can effectively measure and report on targets and thresholds. For example, if your system captures data elements such as service and bill date, you can easily measure and monitor charge lag, or compare data to service period and financial period.
• Third, keep your benchmarks realistic. Don't set thresholds that sound good but in reality don't allow you to extract the appropriate data on a scheduled or as needed basis. Your practice management system is unlikely to provide data regarding clinical orders, just as your EMR is unlikely to provide data regarding CPT utilization. Instead, set benchmarks which correlate to the available data and timing. It is also important to understand how reports are generated; if you must request reports from a centralized location, be sure to clearly identify the parameters of data and timing to ensure you receive the appropriate information.
If you would like to share your RCM best practices, please email Carrie Pallardy at cpallardy@beckershealthcare.com to be featured in the "RCM tip of the day" series.