A recently released whitepaper offers a number of different revenue-cycle benchmarks for outpatient surgery centers, including how long it should take to collect on unpaid bills and the overall collection rate.
Billers and collectors, for example, should be following up on 95% of their open claims every month, according to the whitepaper, which was published by Regent RCM. The number of claims being touched every month illustrates the amount of work that a facility or collector is doing to try and collect on accounts.
An overall collection rate should be 97% or higher, the whitepaper concludes. That includes payments from individuals and insurers. If a facility’s collection rate is less than that, it could be a sign that the facility or the collector is not fighting hard enough for what it’s owed, the whitepaper’s authors concluded.
“It’s all about getting paid what we’re contracted to get paid,” said Erin Petri, Regent RCM’s Director of Revenue Cycle Management. “For example, if we’ve done 200 cases and our contracted rate for the 200 is $400,000, our job as revenue cycle experts is to collect $400,000. We know that there’ll always be exceptions, such as patients that go to collections because they just don’t have the money to pay their responsibilities – that’s bad debt. There will be things like a denial because you didn’t get an authorization and the payer just won’t pay it – that too becomes a portion of bad debt. But ideally, we should collect 100% of our contracted amount. Given those considerations, being at 97% is very good.”
