Introduction
The Key Performance Indicators (KPIs) are easy-access figures to give you a snapshot of the current financial health of your practice. They will help you track the efficiency of your revenue cycle benchmarked by past performance. Some questions the Key Performance Indicators could help you answer include:
- What does my overall production for this month look like, compared to the last six months?
- Has my practice gotten better over time at sending out claims that are not ultimately denied by payers?
- What proportion of my practice's outstanding balances are aged, and may need more immediate attention?
Key Objectives
- You will learn how to locate the key performance indicators in Canvas.
- You will learn how the Revenue KPI is calculated.
- You will learn how the Denials KPI is calculated.
- You will learn how the Aged AR KPI is calculated.
Video
Step by Step
- Begin in the Schedule View
- Click on the triple line menu
- Select Settings
- Locate and open Report Jobs under the Reports section
- View the Key Performance Indicators at the top of the page
Revenue
The Revenue KPI shows your practice's gross patient service revenue for the current calendar month and compares this month's revenue so far to all months in the previous year.
While the Production report can give you the ability to further break down the month's revenue by various categories, this figure gives a much quicker snapshot of how the month is going relative to the past year.
Includes:
- The sum of all charges on all claims, separated into calendar months by the Date of Service.
Excludes:
- All charges from claims are currently in the Trash queue.
Denials
The Denials KPI gives a trending indication of the percentage of claims that are being sent back by insurance payers with "denial" adjustment codes, grouped by the date the remit was received. If there were no insurance postings during a month or period of time, that month will not be displayed in the KPI.
The objective is to be able to get a quick look at your current claims processing efficiency, and ideally, see the benefits of process improvements as the percentage of claims being denied decreases month over month. Conversely, a quick glance could show if the past month has had abnormally high denials and prompt further investigation.
For a deeper dive into the adjustment codes, your practice is seeing over any time period, you can generate an Adjustments report.
Includes:
- All claims that received a remit with a "denial" adjustment code, divided by all claims that received a remit, regardless of adjustments.
- The list of "denial" codes can be found in the Adjustment Codes article. These denials are defined as being "actionable" - meaning they can be addressed and corrected to get appropriate payment.
- If any line item with one of these codes is on the remit, then the entire remit is counted as a Denial.
- Both initial claim denials and any appeal denials
- Zero payment accounts
Excludes:
- Claims where no remit was received (i.e. Self-pay accounts)
- Denials for non-covered services
- Courtesy write-off adjustments
- Patient responsibility adjustments
- Duplicate claim denials
Aged AR (>90 Days)
The Aged AR KPI shows you the percentage of your overall outstanding balance that is currently "aged", meaning it has been over 90 days since the original Date of Service for the encounter. It will also show you the total number of claims with an aged balance, and the total dollar amount of that aged outstanding balance.
The objective is to give a snapshot at how effective your practice is at liquidating aged account balances. As these figures are all dynamically updated, any aged balance you settle will immediately be reflected with a drop in this Aged AR percentage.
Includes:
- Only active billed debit balance accounts
Excludes:
- Any account not yet billed to the payer or patient
- If the overall account balance for the encounter is a credit, the account is not included
Roles
- Billing staff
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