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5 EMS Billing Metrics That Matter

Posted on November 14, 2016

ESO Solutions offers EMS billing software that helps to automate your workflow and put an end to repetitive manual work associated with revenue-cycle management making your billing processes easier and faster. Below we’ve outlined 5 measurements that should be on your radar if you’re looking to increase the success of your billing systems.

WHAT TO MEASURE

QA/QI rate for billable incidents

WHAT SUCCESS LOOKS LIKE

You ensure that every billable incident has a corresponding EHR/ePCR that’s been imported and accounted for in your billing software. At this stage, you also routinely identify and address claims that lack critical billing information.

WHAT TO MEASURE 

At-risk claims rate

WHAT SUCCESS LOOKS LIKE

You consistently identify claims that are at risk of missing deadlines. You immediately categorize and assign such claims to a pre-bill workflow for timeline follow-up. Categories should include: missing PCS; missing insurance; incomplete PCR; and missing signature.

WHAT TO MEASURE

Percentage of rejected or denied claims

WHAT SUCCESS LOOKS LIKE

You regularly monitor your percentage of claims that are rejected or denied. In addition to watching for numerical trends, you look for the reasons behind the denials and take appropriate action.

WHAT TO MEASURE

Number of outstanding claims

WHAT SUCCESS LOOKS LIKE

You keep this number low by setting up alerts to identify claims as soon as they exceed your organization’s specified timeframe for payment. You routinely assign every outstanding claim to a staff member for individual follow-up.

WHAT TO MEASURE

Payments posted

WHAT SUCCESS LOOKS LIKE

You monitor reimbursements received against past performance and expectations for payment. You have alerts in place to catch when payments do not meet expectations. Your payments received match or exceed your organization’s revenue goals.

Ask your billing software vendor if they have pre-built reports, alerts, and workflows that can make it easier for you to measure these billing metrics — and improve your results.

“Want to maximize your organization’s revenue while minimizing time to reimbursement? From the QA/QI process to receiving payment, here’s what you should be measuring.”

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