Any successful practice has goals that the practice owner measures regularly to ensure that the practice is succeeding. Whether it’s new patient acquisition or optical capture rate, these optometric practice metrics could indicate that your practice is growing and moving in the right direction. However, these aren’t the only key performance indicators that your practice needs to be aware of. Below are three optometric billing metrics your practice should monitor to improve on claim reimbursements.
Improve Practice Performance with These Optometric Billing Metrics
Claim Acceptance Duration
The longer it takes for a payer to accept your claim, the less your practice makes on its bottom line. Reworking claims costs money and takes away from your biller’s ability to work and submit new claims. Recording errors, like bad ID number or missing information, can cause the claim to be kicked back to your practice for resubmission, extending the time it takes for a claim to make it through the lifecycle.
An important sub-metric to identify when calculating the claim acceptance duration is to measure your claims’ first-pass acceptance percentage. If your first-pass acceptance percentage is low, it signals that your biller has to make the corrections, resubmit the claim, and restart the claim management lifecycle. Anytime a claim doesn’t successfully make it through the life cycle, it means the practice is losing money and productivity.
Monthly Denial Rate
Most reasons for claim denials are common. The good news is that they are preventable if you take the time to measure your denial rates. Examining your monthly denial rates helps your biller identify the reasons for the claim denials. As these reasons are identified and corrected, your practice can improve your first-pass acceptance percentage, decrease the claim acceptance duration, and increase your cash flow from claim reimbursements.
Monthly Income Amount
Now, here’s the statistic that every practice owner wants to know: monthly income earned from claim reimbursements. While this is obvious, many practice owners don’t know the amount of money they’re making from insurance claims and how that number measures against other optometric practices in their state or across the nation.
If the number is higher than state and national averages, then great job! You’re doing what you need to. However, if you’re making less than the comparisons, then it’s time to dive into your claims management metrics to identify the causes.
For tips on how you can make more money on your claims reimbursements download, "The Definitive Guide to Making More Money on Claim Reimbursements."