Performance Analysis
About Performance Analysis
Medical billing performance analysis uses Key Performance Indicators (KPIs) like Days in A/R, Clean Claim Rate, and Denial Rate to measure efficiency, identify bottlenecks, improve cash flow, and ensure accurate reimbursement by tracking financial health and operational effectiveness. Analyzing these metrics helps streamline processes, reduce errors, optimize revenue, and make data-driven decisions for better financial outcomes.
Measuring Billing Success
Key Performance Indicators (KPIs) in Medical Billing
Days in Accounts Receivable (A/R)
Average time to collect payments; lower is better (aim for under 45 days).
Clean Claim Rate
Percentage of claims submitted without errors, indicating coding and entry accuracy.
Claim Denial Rate
Percentage of claims rejected by payers, highlighting process issues or payer problems.
Net Collection Rate (NCR)
Actual collected payments versus expected revenue, showing overall collection effectiveness.
Charge Lag Time
Time between service and claim submission, affecting cash flow.
0-60% A/R
Focuses on cash flow from the most recent (0-30 and 31-60 day) claims.