Unlocking Financial Success: The Importance of SNF Billing KPIs

How do you know your Skilled Nursing Facility (SNF) performs well? Key Performance Indicators (KPIs) give you deeper insight into the process. By regularly tracking the right quantitative measure of the performance of skilled nursing facility billing, you can identify the gaps within the process and implement a correct strategy to eliminate the issues.

“Is my facility meeting the financial goals?”- It is a question that might come to your mind now and then.

Perhaps you would rattle off a set of metrics you are tracking. Or maybe you are not sure how to answer this question. Either way, it is almost impossible to find an answer with a simple ‘yes’ or ‘no’. To adequately answer this question, you must have an in-depth knowledge of the metrics of your facility should use a major financial success.

Whatever the size of your facility, it is always good to keep an eye on the financial health of your practice. To ensure optimized revenue you must ensure efficient skilled nursing facility billing and coding process. A defined operation of the administrative tasks helps you to sustain the growth and income of your practice.

What is a Key Performance Indicator?

As the name suggests, it explains your practice’s overall performance whether it is financial or functional. It is a measurable value that indicates how well you are achieving key business objectives.

KPIs can be used to track several business objectives. However, the key to a strong KPI is that it must be measurable. The most effective KPIs provide you with data points that you can compare over time and help you to identify trends and potential improvement opportunities.

How to Pick the Best KPIs for Your Establishment

It's critical to comprehend the metrics that matter most to your billing department when choosing a KPI. Accounts Receivable (AR) is one example of a seemingly simple option. You may delve deeper into more precise AR measurements, though. metrics that will aid in the future development of operational management and decision-making.

Examine the KPIs that your medical billing team is currently monitoring to get started. This will provide you with an overview of your current situation. Additionally, assists in determining whether the KPIs you are currently tracking meet your operational imperatives, give you adequate information, and are measurable.

Remember that following too many KPIs might become stressful. Pay attention to the KPIs that pertain to the work that your team of medical billers and coders performs. Any areas where you may improve will become evident if you narrow your attention.

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The Top 3 Skilled Nursing Facility Billing KPIs You Must Track

To ensure enhanced performance of your skilled nursing facility when you decide to track the KPIs, the following are a good place to start:

1) Clean claim rates (CCR):

Clean claim rates indicate the quality of the claim submitted on the first attempt. A CCR of 90% or above indicates good skilled nursing facility billing performance. A high CCR means decreased cost, less time in AR, and improved cash flow.

2) Days in AR:

An SNF’s accounts receivable days provide insights into how long it takes to collect balances after billing. This includes payments that have not been collected yet for both insurance reimbursements and out-of-pocket services. Healthy AR metric should be 30 to 40 days. AR days higher than 50 indicates you are less likely to receive payments for those services.

3) Denial rates:

Denial rates show how many claims are denied. Denial rates in the U.S. healthcare industry range from about 6 to 13%. A large percentage of claim denials are due to errors in medical billing and coding. If your denials rates are high, it is important to drill down into reasons.

Expert Help to Improve Your SNF Billing KPIs

Identifying and monitoring KPIs for skilled nursing facility billing is important and a great first step. Yet, making improvements in KPIs that you are struggling with can be a challenge. Therefore, it is beneficial to have an expert medical billing and coding partner with you. With their extensive knowledge and understanding, they can streamline your processes while ensuring HIPAA compliance within your services. This way they safeguard your data and save you from legal and financial consequences.

Choosing a partner who can transform your ROI and enhance your revenue generation in the long run can be difficult. Hence find a revenue cycle management partner who can provide you with an end-to-end service while driving your facility’s growth.