Revenue Integrity Productivity Metrics/KPIs

Memorial20Memorial20
in GENERAL

For those working in Rev Integrity, I am interested in learning how other organizations measure department productivity and effectiveness. What metrics or KPIs do you use to evaluate your team? In particular I would be interested in measures related to Audits completed per FTE or per month, Identified and recovered revenue, prevented revenue leakage, denials or underpayments identified, and/or provider education or process improvement activities. What metrics did you use to determine the size of your Rev Integrity team?

Thank you for any feedback you are willing to provide.

Comments

  • bussiek@chop.edubussiek@chop.edu

    I am providing how to measure the success of Revenue Integrity operations and how to determine the size of your Revenue Integrity team.

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    In addition, there are four options to consider when determining RI staffing models:

    1. Productivity: Audits completed per FTE, audit turnaround time, audit findings per Audit, Education sessions delivered, Process improvement initiatives implemented
    2. Financial Impact: Revenue recovered, Revenue leakage prevented, Underpayment recoveries, Financial Impact per FTE, ROI of Revenue Integrity Program
    3. Effectiveness: Primary denial rate, Clean paid claim rate, Avoidable write-off rate, Appeal success rate, Charge capture accuracy
    4. Strategic Impact: Revenue protection dollars, Automation savings, Provider adoption rate, Repeat finding reduction, Estimated annualized benefit
  • Memorial20Memorial20

    Thank you for providing the detailed information needed to develop productivity measures. This information will help me build a KPI spreadsheet and present a clear picture of the work completed across our department.

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