The world of revenue cycle management (RCM) is full of acronyms and jargon. Even seasoned billing experts can get disoriented with the jumble of letters and numbers flying through their heads.
But when it comes to healthcare revenue cycle KPIs, or key performance indicators, keeping those letters and numbers straight is critical — it’s a matter of business success and failure. You also need to know the benchmarks for these KPIs and whether your organization measures up to these standards.
Why Revenue Cycle KPIs Matter
There are many different metrics you need to track to run a successful medical practice or healthcare business. Revenue cycle KPIs not only help you monitor important financial measures, they also help you gauge the health of your operations and find opportunities to improve processes.
Ultimately, a healthy revenue cycle gives your business stability and makes sure you have consistent cash flow. That means you can allocate resources appropriately and grow your team strategically, so you can care for more patients or expand your business.
Healthcare Revenue Cycle Management KPIs: A Glossary
Keeping revenue cycle KPIs straight isn’t always easy. That’s why we’ve created a handy guide you can reference for definitions and benchmarks. You can bookmark this page to reference the guide below, or download the glossary and save it to your computer for convenience.
We’ll make sure to update and add to this glossary as needed. And if you have a suggestion for an entry, feel free to email us or reach out on Twitter.
| Key performance indicator (KPI) | Definition | Goal |
|---|---|---|
| A/R >90 | The percentage of unpaid invoices or accounts receivable (A/R) that have been unpaid for 90 days or more. | <10% |
| Average days in A/R | The average number of days it takes to get reimbursements from the date of service (DOS). A/R = accounts receivable. | 35 days |
| Bad debt rate | The amount of non-contractual charges that the business or practice writes off. |
<5%*
*Ideally, insurance should be 0%; however, patient bad debt can be <5%. |
| Cash collection | The percentage of patient service revenue that a business converts to cash. Cash collection = Total cash collected/average monthly net revenue. | >90% |
| Charge lag | The number of days from date of service (DOS) to the date the practice or business enters charges. | Organization-specific |
| Clean claims rate or first acceptance rate | The number of claims the payer accepts divided by the total number of claims submitted in a time frame. | >95% |
| Days to submit | The number of days from the charge entry to the date you submit the claim. | <48 hours (business days) |
| Denial rate | The percentage of claims that payers deny. | <8% |
| Rejection rate | The percentage of claims that payers reject. | <10% |
RCM Can Be Complicated, but You Don’t Have to Tackle it Alone
We get it: revenue cycle management (RCM) isn’t easy. That’s why we’re revolutionizing the healthcare billing and RCM process. The Gentem platform turbocharges healthcare organizations by growing revenue and modernizing the medical billing experience.
With Gentem, you will:
- Increase revenue and collection rate. Our physician-designed technology and expert billing team increases practice revenue by an average of 20%.
- Get full transparency into your business data. You’ll get immediate access to key financial and operational data to grow your business.
- Automate repetitive RCM tasks. Reduce costs up to 30% and minimize errors from manual RCM by using our AI-powered platform. Plus, Gentem integrates directly with your EHR or PM system, so you don’t have to worry about workflow disruptions.
Reach out to one of our medical billing experts today to learn more.
Modernize Your Billing and RCM
Learn how Gentem’s technology can save your organization time and increase revenue. Schedule a demo with our team today.
