Run these 4 revenue cycle management reports to improve financial performance
These days, there’s so much data swirling around in healthcare. It can be overwhelming to try and leverage it to improve financial performance. That is, unless your revenue cycle management (RCM) vendor provides you with concise reports from which you can glean valuable insights—or makes it easy enough for you to generate your own. RCM data (and RCM data analytics) can be a game changer in terms of improving your medical practice’s financial health by providing valuable insights into opportunities, potential compliance vulnerabilities, and so much more.
Not sure where to focus your data analytics efforts? Here are four key RCM reports you can—and should—run regularly.
1. Report: Financial productivity.
What it shows: Total revenue, including charges, receipts, and adjustments.
When to run it: Monthly.
Why it’s important: Ideally, your medical practice financial performance is stable over time from month to month and year to year. If it’s not, it’s time to explore why. For example, do seasonal fluctuations play a role in terms of patient volume? If December is usually a busy month, and then it suddenly slows down, what changed? And more importantly, why? For example, has the healthcare staffing shortage negatively impacted the patient experience and decreased patient retention at your medical practice? Or if your patient volume suddenly spikes, what did you do differently? For example, did you implement self-scheduling so more of your available appointment slots are full? Did you partner with an outsource RCM vendor to promote smoother cashflow and fewer claim denials? Data analytics can help you find the answers so you can do more of what’s working and less of what’s not.
2. Report: Procedure analysis.
What it shows: Volume of procedures (by CPT code) and associated revenue generated.
When to run it: Monthly.
Why it’s important: You can easily glean what procedures generate the bulk of your revenue and identify potential areas of under- and over-coding.
3. Report: Payment analysis.
What it shows: Breakdown of total payment transactions by type (i.e., cash [for insured patients], check [for insured patients], credit card [for insured patients], specific insurance company, or self-pay [for uninsured patients]) and associated revenue generated. It’s also helpful to look at each payment type’s percentage of total revenue.
When to run it: Monthly.
Why it’s important: You can easily spot your biggest payers in terms of volume and dollar amounts. These are the payers to target when renegotiating contracts to ensure favorable outcomes. You may also be able to identify payer contracts to terminate due to low (or no) volume. In addition, you can better understand the impact of the patient financial responsibility on your bottom line, including self-pay patients and implement strategies to improve patient collections (e.g., leveraging the patient portal and promoting online bill pay).
4. Report: Daily summary.
When to run it: Daily—by date, provider, and location.
What it shows: Total charges, payments, debit adjustments, credit adjustments, and net revenue.
Why it’s important: A daily snapshot of your medical practice’s financial health is important because it provides ongoing feedback and an opportunity to intervene immediately, if necessary. For example, if you suddenly start to see a decrease in payments, you can act quickly to determine why. Did a particular payer implement a new billing edit or payment policy for a CPT code you report frequently? Did you forget to stop reporting an invalid ICD-10-CM diagnosis code starting on October 1 causing a sudden increase in claim denials? Segmenting the data by date, provider, and location allows you to home in on the root cause of potential problems, provide additional education, and take other corrective actions.
Leveraging data analytics in your medical practice
These are just a few of the reports you should run regularly to make the most of your data. The more frequently you review the data, the more quickly you can act. Finding the right RCM partner can make a big difference in terms of gaining valuable insights into financial performance. Learn how edgeMED can help and be sure to check the Healthy Snacks blog for more expert insights, best practices and industry trends.
