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Leadership is getting people to want to do something. Management is the process of getting there. Measurement is the tool that tells you how you’re doing. Without measurement, it is impossible to know if your team is effective in their jobs. Back in the day when making money in healthcare was much simpler and more lucrative, many docs were content to use their checkbook balance as the only measure that mattered. Lots of money in the account meant everybody must be doing their job.
Right.
In our world we measure two things: Speed and accuracy. Well, that’s not really true. Actually, we measure lots of things, all of which boil down to speed and accuracy. Speed without accuracy equals unclean claims and harmfully affects cash flow. Accuracy without speed is better, but is expensive and ultimately cost-prohibitive. Ideally, we want lots of speed and lots of accuracy. Knowing that people do what’s inspected, not expected, there are several metrics that can help us progress toward the best possible results. By category, we look at the following...
- Clean Claim Rates
- Denials
- Claim Velocity
- Payment Velocity
- Follow-up Success
Each of these areas includes several metrics for evaluating success. As with all metrics, trends analysis is important, so compare results from user to user, and month to month. In Part II, we'll break them down in detail.