We can start answering questions in real time, like, What is your work effort rate? How many claims/charges get paid without a human touching it? We can’t know if we are just relying on practice management data. They are not capturing everything you need to measure every unit of work. When I look at views like this, it starts to provide real transparency in real time as to where I need to focus my effort to reduce my dependence on labor. If you look at the zero touch rate in this client above, for example, 50.6% of the charges that go out get paid without a human touch, but half of the charge require a human touch. You can see what percentage of work effort (4.6) is going to clearing the edits. Look at the refile visits rate (7.1%) and the denials (38.9%) in the screenshot above by certain physicians. What’s going on in financial clearance and in coding? What are we not doing right that a human is now having to correct and hopefully get paid what we are suppose to be paid in a reasonable amount of time. Look at the work effort into getting claims paid.
These are measurements that you need to have especially in this day and age where everyone wants higher pay and to work from home. So you have to reduce your labor dependence. We have to go back to the basics of profit margin. Automation is critical, but automation is not going to solve the human problem in its entirety. You will always have humans involved in a process within the healthcare revenue cycle. The key is to minimize that, but you can’t if you aren’t aware of where the breakdown is occurring.