The Medicare claims process is not for the faint of heart and can be frustrating even for the most seasoned hospital biller. Billing Medicare is one of the most complicated yet critical tasks in hospital revenue cycle management. The process is distinctly different from billing commercial payers, with Medicare-specific requirements and systems.
For healthcare providers, claim denials are just a routine part of business. It seems you can’t completely escape them no matter how hard you try. You’ve heard the statistics: The average claim denial rate across the healthcare industry falls between five and 10 percent, according to an American Academy of Family Physicians (AAFP) report.
In a recent survey of hospital CEOs, the American College of Healthcare Executives reports that CEOs ranked financial challenges as the number one issue facing hospitals. Some of the top financial challenges these CEOs identified include Medicaid reimbursement, revenue cycle management, managed care and commercial insurance payments, and reducing operating costs.
It's clear hospitals should track specific financial key performance indicators (KPIs) to monitor and evaluate financial health and profitability. But at every turn, hospitals are expected to measure and deliver indicators – from quality to financial to clinical to operational. With so many required indicators to report, it may feel overwhelming for hospital leaders to know exactly which financial KPIs they should track. Our hospital revenue cycle experts at eSolutions have created a list of the top 5 financial metrics any hospital should closely watch.