Is your organization financially healthy? When trying to answer that question, an abundance of information can sometimes be just as problematic as a dearth of data. In the face of endless analytics, what are the key metrics that behavioral health care companies need to understand in order to thrive?
1. What is your denial rate?
The denial rate is the percentage of claims that are denied, out of all of the claims submitted. It’s a key indicator of the success and efficiency of your claims process. When this number is high, there could be several underlying issues. Are your employees educated about the correct coding and claims submission formats? Does your billing company know what errors to look out for before submission? Are you effectively using your ERA (electronic remittance advice)? Working with an experienced and efficient billing company can help reduce your denial rate substantially over time, increasing your revenue.
2. What is your DRO (Days in Receivables Outstanding)?
The DRO is the average number of days it takes your organization to collect on owed revenue. It is calculated by subtracting your credit balance from total receivables, and dividing that by your average daily charge. If this number is greater than 60 days, there is huge room for improvement. Working with a billing company can bring your DRO down below 30 days, by streamlining your billing, preventing denials, and ultimately getting you more money, faster.
3. What is your Collection Per Total Relative Value Unit?
Your collection per total relative value unit shows how much you’re getting paid for your services—and whether you should be getting paid more. For example, your CPT/RVU for major insurance carriers should always be higher than the current Medicare Conversion Factor. (The Medicare Conversion Factor is how much Medicare would pay for a code worth 1 RVU.) The current Medicare Conversion Factor is $36.09 for 2020. This metric ensures that you’re getting paid what your services are worth – and then some.
Of course, all of these metrics can be calculated by hand, but it’s a time-consuming process that’s highly susceptible to human error. At Billing Solutions, we offer a best-in-class data portal, Nectar, that can perform the real-time calculations to show you Key Performance Indicators in real-time, 24/7. You’ll know for sure whether your billing process is getting you the revenue that you deserve. If not, you’ll be able to see where you can fix it.
Interested in learning more about how that works? Input your information below to get a free account analysis and demo of our Nectar Portal. You don’t ever have to feel confused about your data again.