“What gets measured gets improved.”
Sypore services are built on a firm foundation of data driven processes that are purpose engineered and supported by state-of-the-art technology platforms.
We believe in data-driven decision making so that our actions are based on objective insights. This is a key reason why all our customer see a tremendous positive change in their financial performance within 60 days of starting with our revenue cycle management services.
We believe in this methodical approach so strongly that our Billing Service agreement binds us to deliver a quarterly financial performance analysis to each and every one of our customers; complete with the good, the bad, and the ugly along with the root causes for each. No other company in our industry that we know of does this proactively and writes it down in its service agreement!
Below is an excerpt from one such analysis (contact us today to receive your own complimentary financial analysis):
The purpose of this analysis is to provide feedback on:
- Annual volume metrics
- Claims level reimbursement metrics
- Claims level billing efficiency (timeliness) metrics
- Denials analysis with primary root cause identification
- Comparison of reimbursement to peer group (National database from MGMA)
- Accounts Receivable (A/R) metrics in comparison with Best in Class Practices
- Recommendations on Financial Performance Maximization opportunities
|Cash Collections Level||Cash collection per claim is around $134 with approximately 22% additional room for improvement. This is significant.|
|Accounts Receivable Days||Days in A/R is over 140. This is “Very Poor Performer” in this category. The target for this metric is under 35 days.|
|Accounts Receivable Risk (Over 90 days)||Percent of A/R over 90 days is 80.2%. This is “Very Poor Performer” in this category. The target for this metric is under 12%.|
|Net Collections Rate
(Amount collected as a % of Allowed Amount)
|Net Collections Rate is under 78%. This is “Poor Performer” in this category. The target for this metric is over 98%.|
|Claim Submission Lag (Days to initial claim submission)||Average submission lag is 14 days. This is “Poor Performer” in this category.
To be “Best Performer” in this category, this metric should be under 2 days.
|Cash Collections Efficiency (cost)||Not measured – data not available||To be “Best Performer” in this category, this metric should be under $10 per claim including costs of staff labor or service fees for:
Provider Productivity is high in terms of number of patient encounters per full-time equivalent (FTE) provider. Average encounters are about 769 per month.
Reimbursement in terms of cash collected per claim (on average) is about $134. This is good but has ample room for improvement with a target of around $164 (22.4% improvement).
Accounts Receivable management indicates ample opportunity for improvement as it appears that rejections and denials are not being worked consistently and aggressively. This is leaving approximately $350,000 in possible reimbursements at risk of loss (longer the A/R ages, lower the probability of collecting at 100% of its allowed value). This also increases the cost of capital due to a cash conversion cycle, which entails utilization of resources which could be utilized elsewhere. Without reviewing the write-off policy and the historical amounts written-off in the last fiscal year, it is not possible to more accurately gauge the performance in this area.
Labor cost of Revenue Cycle Management was not measured as data on staff-related cost or external billing service fees was not available. For this type of practice, the all-inclusive labor cost of revenue collection should be no more $10 per claim.
Sypore believes it can help increase net collections by at least 20% and reduce billing related costs for the practice to less than 6% of net cash collections.
(Additional details, data tables, and charts removed for brevity.)