Procedures and protocols are important to set forth so your staff are all operating from the same best practice playbook.

Many practice managers and providers tell us that they would like to create a higher degree of accountability for results because quite frankly, they care less about how their staff achieves a greater than 92% accuracy of claims on first submission so long as no one gets hurt or finds themselves on the business end of a phone call from the Medicare Fraud and Abuse Squad.

Managing performance often entails a revision of the standard job description because these descriptions are often little more than a list of tasks without the expected outcomes associated with the tasks. To help you in this area, you will find, throughout this blog, recommended performance indicators for each component of the revenue cycle. Feel free to use these indicators as the benchmark for evaluating staff performance.
Some common indicators include:

• Percentage of claims submitted correctly the first time
• Claim edits and denials due to missing or incorrect registration and referral information
• Number of patients cleared prior to visit
• Error rates due to front-end billing
• Time of service collection percentage
• Days in AR
• Date of service to date of documentation lag time
• Date of coding to charge entry lag time
• Date of charge entry to date of bill release lag time
• Percent of missing charges for services documented
• Charge corrections due to coding errors
• Claims denied due to coding issues
• Charge corrections due to charge entry errors
• Aged AR by payer
• Percentage of AR over 90 days