Summary
In this RCM Experts Podcast episode, host Carrie Bauman talks with Mark Anderson, a leading healthcare IT futurist. Mark, drawing from his vast experience with hundreds of hospitals and practices, shares his "recipe" for assessing revenue cycle health using 13 key performance indicators (KPIs). He highlights the importance of measuring success at each stage to reduce revenue leakage and boost collections.
The discussion covers pre-care processes, accurate coding, and achieving a high clean claim rate to minimize rejections. Mark also emphasizes the need for AI-powered denial management systems to eliminate root causes, not just track them, and stresses proactive claim follow-up for timely payments.
Key Takeaways
- Mark's "recipe" for revenue cycle health uses 13 key performance indicators.
- A 95-98% clean claim rate is a top benchmark for performance.
- Focus on eliminating denials by addressing their root causes, aiming for near-zero.
- Proactive claim follow-up is essential to prevent payment delays.
- AI tools are critical for data analysis, identifying revenue leakage, and managing denials.