Stay Ahead With Revenue Cycle Key Performance Indicators (KPI)

by | March 28, 2022 | 6:56 am
Stay Ahead With Revenue Cycle Key Performance Indicators (KPI)

Identifying business KPIs is the key to ensuring business goals are on track and can continue to guide the business accurately. According to Business News Daily, KPIs  guide businesses in the right direction.

To be effective, KPIs are typically:

Specific: Specific KPIs are assigned numeric values or percentages. For example, ‘15 percent growth is expected in the next financial year’ is specific. However, saying, ‘Growth is expected in the next financial year,’ is vague.

● Measurable: Assigning a particular growth percentage to revenue can make it a measurable KPI.

● Impactful: KPIs must measure the impact a particular effort or activity brings to the business.

Revenue Cycle Key Performance Indicators

Identifying KPIs relevant to your business is, thus, critical to business success. KPIs also need to be trackable. Unless businesses regularly and consistently track KPIs, there is no way to know whether they are effective. At the end of a specific period, for example, the financial year, businesses must determine whether the KPIs were met and to what extent.

Revenue Cycle KPIs

Medical billing KPIs can help optimize the revenue cycle. They can prove more effective for DME revenue cycle management. Choosing KPIs oriented to revenue growth can be practical and highly effective in helping businesses track and meet planned growth goals.

Here are three powerful revenue cycle KPIs that can be leveraged by businesses:

#1. Insurance Eligibility Verification

A significant part of DME billing comes from insurance payments. Insurance eligibility verification is a critical part of ensuring your DME gets paid. There are several elements to insurance eligibility verification, such as in-network equipment provider, insurance premium amount, and proportion of premium payable by the patient.

To ensure eligibility verification, it is necessary to train staff and connect resources to continue working without interrupting current business needs. This can include tech adoption and adoption of new practices and ways of working to ensure uninterrupted operations.

Challenge: Staff can face burnout if not managed effectively.

#2. Measuring percentage loss of business

A DME practice is not typically patient-facing. Thus, losing business must be closely examined, and reasons behind any lost business or equipment orders uncovered and analyzed to understand underlying causes. Keeping claim rejections and delays to a minimum can fall under this KPI. Businesses must recognize that this work can be time-consuming, especially for in-house staff, often already managing many tasks.

Challenge: Determining problem areas within the business can prove challenging.

#3. Delayed billing

There can be several reasons for delayed billing. A few of these are missing the deadline and providing incorrect information.

Claim submissions need to be timely. When filings are incorrect, claims can be delayed or rejected. Re-applications can take time, costing even more moneys.

Challenge: Incorrect information for the claim application can lead to overburdened staff and loss of focus on business activities.

Leveraging professional assistance

Accessing professional assistance can help ensure effective KPIs. Professional DME partners can streamline operations and ensure that claim submissions are complete. This includes insurance eligibility verification, timely billing, and accurate measurement of business losses. Professional assistance enables DME businesses in multiple ways:

–> Shift the focus back to critical business-building activities

–> Decrease the risk of staff burnout and attrition, especially after investments in training

–> Ensure deadlines are followed

Ensure accuracy of the information on claim applications to reduce delays and re-applications.

Next Steps 

–> A DME partnership can provide the proper assistance and expertise to reliably manage DME/HME billing requirements such that business profitability increases. Learn more about our medical billing at 

–> Email us at or call 781.503.9017 for a free session. 

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