Below are some practice guidelines for your consideration. Most of these are in regards to your receivables but there are a few operational guidelines as well. For phlebology practices, the number of claims that ‘age’ due to notes requests and denials will always be higher than the non-specialty standards noted below.
1. Visits without charges as a percentage of total visits.
0%
2. Copay collections as percentage of total copay office visits.
Greater than or
equal to 95%
3. EDI claims as a percentage of total claims billed.
Greater than or
equal to 90%
4. Charge entry lag period.
Equal to or less
than one business day
5. Claims passing claims edits as a percentage of total claims.
Greater than or
equal to 98%
6. Appointment no show rate.
Less than or
equal to 3%
7. Appointment bumped rate.
Less than or
equal to 3%
8. Net A/R days (non-specialty).
Less than or
equal to 40 days
9. Collections as a percentage of net revenue.
Equal to or
greater than 100%
10. Collections as a percentage of gross revenue (non-specialty).
Equal to or
greater than 60%
11. Third party A/R aging greater than 90 days from last activity date.
Less than or
equal to 10%
12. Denials as a percentage of net revenue (including “incidental to” services).
Less than or
equal to 2%
13. Claims with no activity greater than 90 days from last activity date.
0%
14. Credit balances.
Less than or
equal to 2 A/R days
15. Average patient wait time after office arrival.
Less than or
equal to 15 minutes
Published in HFM, July 2007, Magazine for the Healthcare Financial Management Association. Written by David C. Hammer. Posted by kind permission by Mr. Hammer.
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