Many practices have managed to settle with the new ICD-10 according to payers and clearinghouses. Well, are things really moving in the right direction? This picture will get more clear when remittances will start coming in in a proper manner.
With monitoring your productivity, you need to watch the cash flow too. You need to know about the issues related to halted or delayed reimbursement.
The top metrics to monitor the productivity of ICD-10 performance are:
1. Productivity of coders
The factor of productivity varies on the basis of type of institution, quality of physician’s reports, training levels and well versed staff. For ensuring the productivity of coders you need to remain intact in asking the following questions:
- Are coders struggling with various speciality coding?
- Time spend in non coding tasks.
- Domains that requires more training.
- Is documentation gap leading to loss in productivity?
- Any changes required in the current workflow?
- Is there any need to use CAC (computer-assisted coding)?
2. Volume of queries
Your concurrent queries need constant comparing and monitoring to keep volume in check. You need to keep following pointers in mind:
- Can you use templates for collecting documentation electronically?
- Is there increasing trend in queries? Is it related to any specific providers?
With CDI specialists you can have increased anatomical and laterality knowledge as they possess the most immediate knowledge which your staff may not have. You need to have a collaborative team of CDI coderss with crystal clear conversation to avoid confirming the same information again and again.
3. Flow of revenue cycle
The ultimate aim of physicians is to have an effective revenue cycle. You have to undertake changes that are required to improve claim submission and channel information into the billing system. If your A/R is jumping that means a huge fluctuations in cash flow. You need to follow these record types:
- Inpatient and outpatient records
- Surgery performed on same day
- Recurring accounts
- Emergency department records
4. Addressing coders questions
It is helpful to have a system designed that can submit all the questions of coders to the experts that can address their concerns and track responses. If their queries are not addressed consistently then it can result in causing ruptures and delays in the coding procedures.
5. Payment frequency
The duration required for getting your claim submission paid should be taken into account. This is an important metric because if the insurance company is not paying you on time, then it can disturb your revenue cycle badly. You need to make an account of the days any insurance company is delaying your payment.
DTFB is the time taken by providers to generate the bill and sending it to the insurance company for reimbursement. Your AR can also get affected by:
- Delayed charges
- Increased queries
- Rise in documenting specific needs.
You need to check the areas that can lead into the denial or delay in the frequency of your receiving payment.
6. Denial rates
Keep a track on the claim denials by following these tips:
- Track payer response
- Types of edits and how often you face them
- Build a mitigation strategy on the basis of derived information.
Apply these measures to have a wider idea about your performance with the transition into ID-10. These metrics will help you in identifying the problematic areas while there are chances to fix them.