Revenue Cycle    

                              Key Performance Indicators In the Revenue Cycle 

Why is it important?

• It evaluates the performance of the department.

• It shows if there is improvement or the need of improvement.

• It helps the company focus on what is needed to succeed.

    
    Key Performance Indicators are used to measure the performance of the

departments. It gives the company feedback on how it is doing and what it needs to

do better. It is a great source to use in the revenue cycle to track the performance of

the department. It can increase accurate and faster reimbursements. 

Top 5 Key Performance Indicators in the Revenue Cycle 

• Days in Accounts Receivable

• Clean Claim Rate

• Denial Rate

• Charge Lag

• Write-Off Percentages 
   There are many Key Performance Indicators (KPIs) that are used for revenue cycles. The

revenue cycle is critical part of any organization.  The whole revenue cycle needs to

monitored from the moment the person comes in for services until the reimbursement is

received. 

   Two important KPIs that are used for a revenue cycle are days it takes to enter a charge of

service(charge lag) and days it is in accounts receivable. 

 Possible errors that will cause delays in reimbursements. 

Charge Lag  Days in Accounts Receivable 

Provider not finalizing their notes. Duplicate Bill that needs to be clarified.

Code Queries not reviewed. Incorrect Diagnosis Code.

Overwhelmed staff and disruption in Incorrect Procedure Code. 

workflow.
How to determine how long it's been in charge lag status or in accounts receivable.

Charge Lag -

• Check the time between the service and bill being submitted is subtracting the date
received from the date of service. 

In accounts receivable-

•  Divide the total A/R by the average daily net patient service revenue using information
from the balance sheet and income statement
There should be questions that • 1.What is your current workflow?

should be asked in regards of Key • 2.How long does it take to process charges?

Performance Indicators. This helps • 3.How do you handle denials?

give the company an idea of what • 4.What is your responsibility for your current role?

they are currently doing. • 5.How much experience do you or your team have with Key

Some questions related to charge lag Performance Indicators?

and days in accounts receivable are:  • 6.What team will you use to review the Key Performance Indicators?

• 8.Are you familiar with benchmarks?

• 9.Will it be difficult to track the current Key Performance Indicators

that are selected?

• 10.How would you track the Key Performance Indicators?

What is a benchmark?

It is when the organizations current performance rate is being compared to the standard

performance rate.

The company will compare their standards to see if it meets the average standard in

performance measures across the nation. 

   The benchmark that is used for charge lags is to submit the charges within 48 hours.

Anything over 48 hours indicates there is somethings interrupting the work flow. 

   According to Regent Revenue Management; “With electronic billing, claim lag is

nearly instantaneous in most ASCs. The gold standard for charge lag is same day of

service –48 hours. If it goes beyond it is time to look at dictation, coding, or invoicing

processes."
    The benchmark for days in accounts receivable is 90 days. Anything over 90 days

may result in a write-off. This will result in loss of revenue.

    According to Regent Revenue Management; “A/R Over 90 Days. We take

contractual write-offs at the time of charge entry; creating a cleaner, more accurate

benchmark. Our gold standard is 20%.”Both benchmarks are reasonable for the

revenue cycle. They ensure that claims are process properly and reimbursement is

received."
 How to Keep Track of KPIs to reach benchmark 

Charge Lag Days in A/R

Daily Excel Spreadsheet  Monthly Excel Spreadsheet 

Separate Columns indicating - type Separate Columns indicating- when the claim

of services, if the services was completed, was requested to be paid, the follow-up request,
were notes processed, and if services were and the day it was paid. There should also be a
charged.  column for any denials and the cause of it.

Review and follow up on any pending Review Claims and Denials. Follow-up on all
charges. denials immediately. 

Should be resolved within 48 hours.  Should be resolved within 90 days if processed

correctly. 
                           References 
Nearterm Blog (Sept. 19, 2019) Top Revenue Cycle Key Performance Indicators Retrieved from
https://nearterm.com/physician-hospital-revenue-cycle-key-performance-indicators-kpis-metrics/

 Regent Revenue Cycle Management (2020)Decreasing days outstanding by managing charge and claims
lag Retrieved from
https://www.regentrcm.com/decreasing-days-outstanding-by-managing-charge-and-claims-lag

Regent Revenue Cycle Management (2020) Revenue Cycle ASC Benchmarks Retrieved from
https://www.regentrcm.com/revenue-cycle-asc-benchmarks#claim_charge_lag

Stewart, A. (May 29, 2019) 9 Revenue Cycle Benchmarks for ASCS Retrieved from
https://www.beckersasc.com/asc-coding-billing-and-collections/9-revenue-cycle-benchmarks-for-ascs.html

Regent Revenue Cycle Management (2020) Measurement and Reporting Retrieved from
https://www.regentrcm.com/measurement-and-reporting

Oachs, P., Watters, A. (2016) Health Information Management Concepts, Principles, and Practice
5thEdition AHIMA Chicago, Illinois