Question
You have been hired as the new Director of Revenue Cycle for a large integrated health delivery organization. The company president feels the revenue cycle
You have been hired as the new Director of Revenue Cycle for a large integrated health delivery organization. The company president feels the revenue cycle process has been running on autopilot for some time and that revenue is probably being left on the table or being lost. no-one in my class seems to be having any luck. it isnt in our book or our powerpoint and google has been a complete let down. I am just taking a shot in the dark thanks for looking at the problem below. Your goal is to review the revenue cycle process and develop key performance indicator metrics that will be used to measure and identify areas needing improvement or change to ensure that revenue is completely captured in an efficient and effective manner. You have decided to concentrate on 4 core process areas of ICD-10 coding, clinical documentation, billing, and collection of payments.
Select company data:
Net Accounts Receivable = $278,000
Total Number of Claims Denied = 1,500
Average Daily Net Patient Service Revenue= $4,700
Number of Correct Coding Data Elements = 5,100
Total Data Elements Required at Coding =6,800
Total Number of Claims Remitted = 45,000
Days between Service Date and Posting of Charge = 7
Assignment: Using the above select company data elements, calculate and or provide the following performance metrics below (a d) and identify which of the 4 process areas each one is used for to measure and monitor revenue management. Show all calculations. a) Claims Denial Rate = b) Coding Quality Score = c) Net Days in Receivables = d) Charge Lag Days = Based on your results from the above 4 performance metrics (a d) above, provide an assessment of the organizations revenue cycle core processes including any areas you feel have an opportunity for improvement and why?
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