Advanced Revenue Cycle Analytics: An Overview

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Managing the revenue cycle in a physician practice is one of the most important and most challenging roles. Without a productive revenue cycle, you don’t have cash flow. Without cash flow, you don’t get paid. This is why revenue cycle productivity is so important. The problem is, it is difficult to measure.

Leverage to Measure Coder Productivity

Coders are the heartbeat of your revenue cycle. You do not get paid without them. And the speed with which you get paid is entirely dependent on them. Many practices are not measuring coder productivity because they do not have the right tools.

One of our clients was experiencing this problem. She had a general sense that her coders were not as productive as they should be, but she had no way to measure it. That is where our AccelaSMART analytics entered the picture. We used analytics to measure how many encounters her coders were processing per hour. The number was 18.27, which is 122 less encounters than the average coder.

Normally when we see a low number like this, the reason is because they are making changes on most of their encounters. If that is the case, we look for opportunities to build better rules. The best practice is to review encounters on an exception-only basis, meaning that you only stop for claims where a change is needed. This client, however, had a low change rate, meaning they were barely making any changes. They should be extremely productive. Through our analytics, this revenue cycle manager was handed the hard data she needed to back up the suspicion that her coders were slacking in productivity.

Leverage to Engage in Productivity Conversations With Staff

Now that the revenue cycle manager has data, she can confidently enter a productivity conversation with her coding staff. In the past, when she had attempted to address their productivity and the possibility for improvement, she was met with defensive attitudes. She did not have the leverage she needed to prove her point and foster productivity gains.

With analytics in hand, it is a different story. Rather than trying to convince her coding staff that they need to be more productive, she can show them exactly how much room for improvement they have. She can set measurable goals, and she can encourage her staff that they are capable of making those improvements.

Leverage For Retraining Opportunities

Many times, coders are slowed down by physicians. Analytics can give insight into which physicians’ encounters are being changed the most often, and why. If Doctor X always upcodes his patients and your coding team is stopping to review and change every one of his encounters, he may need to be retrained on documenting E/M levels. There also may be an opportunity to build a new smart rule that will automatically make changes.

Analytics are an important part of managing your revenue cycle. It is a powerful tool when it is placed in the right hands. We provide Advanced Revenue Cycle Analytics to our clients to give them deep insight into their revenue cycle. To find out how productive your practice really is, schedule a free revenue cycle analysis.