Collection by the Numbers

Kelly Gentry Director of EMR Services Director of Upgrade Services "The content of this presentation represents the views of the author and presenters. GE, the GE Monogram, Centricity and Imagination at Work are trademarks of General Electric Company."

Benchmark - (bench-mahrk) n. a measurement of performance against a standard of excellence. Examples of Clinical Benchmarks  Blood pressure Normal < 120/80  Heart rate Normal < 70 bpm  Body temperature Normal 98.6º F BENCHMARK

Benchmarking Trend Analysis  Growing or Declining Track your fundamental metrics (i.e. performance) over time Monthly charges Monthly payments Monthly adjustments Monthly encounters Average A/R Look for trends (i.e. improving or declining) Model future growth with formula  Graphs Tell the Story Best

Benchmarking Days in A/R  Days in A/R The average number of days an account receivable is outstanding. Measures how long it takes you to collect receivables Mathematical formula Accounts Receivable Days in A/R = Average Daily Collections  Example Calculation Current A/R = $10,000 Average Daily Collection = $1,000 $10,000 Days in A/R = $1,000 per day Days in A/R =10 days

Benchmarking – Days in A/R  Days in A/R 1 Better Performing Clinics – Under 40 days All Other Clinics – Under 50 days  Variance Days in A/R can vary significantly between insurance carriers Medicare and Medicaid can have low DAR Commercial carriers can have higher DAR Days in A/R can vary significantly by practice type Mostly cash clinics have low DAR (Emergency Clinic) Highly specialized clinics have higher DAR Look at the trend for your clinic 1- Statistics provided by Medical Group Management Association (MGMA).

Benchmarking - Collection Ratio  Monthly Collection Ratio The amount of charges collected for a given period Measures how efficient you at collection Mathematical formula (Payments + Adjustments) Collection Ratio = Charges  Example Calculation Monthly Charges = $10,000 Total Payments + Adjustments = $9,000 $9,000 Collection Ratio = $10,000 Collection Ratio =0.9 or 90%

Benchmarking – Collection Ratio  Days in A/R Better Performing Clinics – 98% in 120 days All Other Clinics – 98% in 150 days  Different Type of Collection Ratios Payment Ratio - Payments divided by Charges Adjustment Ratio – Adjustments divided by Charges Non-Adjudicated Ratio – The amount of charges that have not had either payments or adjustments applied

Days in A/R Calculates the average monthly “Days in A/R” that shows the index trend. Calculates the total average for comparison with MGMA best of breed practices. 1 2 A newly created Monthly Financial Summary.

Team Insurance Collection

Work High A/R Carriers First Are you getting the most bang for your collection time? 1 2 Carriers not ordered alphabetically. The amount outstanding is tabulated for every carrier. 1 3 Carriers are then ordered by outstanding amount. 2 3

Work High A/R Carriers First Are you getting the most bang for your collection time? Ticket numbers are provided for fast identification. Patients ordered by outstanding insurance balance. Same patient claims are aggregated for a total.

Team Patient Collections

Work High Guarantor A/R First Are you getting the most bang for your collection time? Ticket numbers are provided for fast identification. Guarantors ordered by outstanding patient balance. 3 Same patient claims are aggregated for a total.

Work Methodically Week 1Week 2Week 4 1.Run insurance report 2.Run patient report 3.Work report top to bottom 4.Working most recent claims first 5.Working claims highest to lowest 1.Run insurance report 2.Run patient report 3.Work report top to bottom 4.Working most recent claims first 5.Working claims highest to lowest 1.Run insurance report 2.Run patient report 3.Work report top to bottom 4.Working most recent claims first 5.Working claims highest to lowest Week 3 1.Run insurance report 2.Run patient report 3.Work report top to bottom 4.Working most recent claims first 5.Working claims highest to lowest

New Patient Notes

Questions? "The content of this presentation represents the views of the author and presenters. GE, the GE Monogram, Centricity and Imagination at Work are trademarks of General Electric Company."

Thank you for watching. Collections by the Numbers Kelly Gentry Director of EMR Services Director of Upgrade Services