Now is the time to conduct a financial review of your medical practice’s 2018 financial performance. Whether you currently handle your billing and coding in-house or outsource to another company, MEREM Healthcare Solutions recommends that you should conduct an annual revenue cycle audit in order to:

  1. Compare your practice’s performance against the previous year.
  2. Compare against industry benchmarks.

Comparing year-end practice revenue and industry benchmarks

At MEREM Healthcare Solutions, it is our mission that all of our clients meet and exceed industry benchmarks. By following this mission, we are able to increase revenue by improving processes.

You should be looking at and comparing the following benchmarks and practice performance to the prior year. If applicable, net collections should be compared by payor as well as by provider or physician.

Consider reviewing national specialty surveys in order to determine if your practice is improving. If not improving year over year, a complete revenue cycle audit may highlight why.

Industry Benchmarks

Industry benchmarks we follow closely to set goals for our clients, include:

  • Gross Collection Percentage
  • Net Collection Percentage
  • Days In A/R
  • A/R Ratio
  • A/R in Excess Of 120 Days Old (Our Client Standard Focuses On 60 Days.)
  • Collection Rates by Payor/ Physician (Payor Mix)
  • Coding Accuracy
  • Clinical/Procedure/Ancillary Encounters
  • Charges by Payor
  • Payor Collections by Physician
  • E/M Coding Comparison
  • Increase Marketing Efforts to Improve the Ratio
  • Front Desk Collection Success (Copayments and Patients With A/R Balances)
  • How Quickly Visits/Procedures Are Billed
  • How Long Does It Take To Get Paid By Payors
  • Percent of Insurance Eligibility Verifications Vs. Total Scheduled Patients
  • Average Number of Missing Charges Vs. Services Rendered (Actual & Cpt Mistakes)
  • Percent of Denied/Rejected Claims Vs. Total Claims Filed
  • Percent of Denied/Rejected Claims Appealed Successfully Vs. Total Denial/Rejections
  • Average Days Between Receipt of Payment and Payment Posted
  • Average Number of Unpaid Claims Resolved by Day Per Collector

 

AUDITING WITH NO FEAR, NO FRUSTRATION, AND NO FAULTS

If you are struggling to meet or keep up with these standards, a billing and coding audit should be performed in order to help you understand the key areas where your clinical operations are weak and can help you to identify priorities and set goals toward making improvements that impact your revenue cycle.

Billing and Coding Audits are valuable tools to help improve your revenue cycle and maintain compliance with CMS and other regulatory bodies. Consider MEREM Healthcare Solutions as an outsourced solution for conducting a complete revenue cycle audit. Our FREE Revenue Cycle Audit tool will help you stay on track with current industry standards and provide unbiased industry comparison and revenue cycle audit report to assist physicians and practice managers with improving their practice performance. Schedule Your Free Revenue Cycle Audit Today!