The field of applied behavior analysis (ABA) continues to see tremendous growth, with services in high demand. This growth is opening up opportunities for new providers and expansion within established organizations. The ability to provide high-quality care to your clients and a valuable work experience for your employees depends on the financial success of your organization. As such, it’s crucial for businesses to closely monitor key performance indicators (KPIs) related to their revenue cycle management (RCM). Read on to review 4 key metrics for financial success in your ABA practice.
1. Average Days in AR
Having high overall collection rates is important. However, it is also vital to look at other metrics such as days in AR. The days in AR metric refers to the average number of days it takes your organization to collect payments owed from funding sources. A higher number of days in AR can negatively impact cash flow and profitability. Therefore, monitoring your average days in AR can help you identify potential cash flow issues and take proactive steps to improve your collections processes.
Collecting money owed from your funding sources as quickly as possible is key to both short and long-term financial success. Aim to keep your days in AR below 50, although 30 to 40 days is the most ideal.
2. Days in AR Greater than 120 days
Along with the average days in AR, you also want to pay attention to how much of your cash flow is coming in past 120 days. This is crucial for any revenue cycle team. If there is a high percentage of funds flowing into your 120-day AR bucket, this indicates systemic challenges, likely related to your pre-RCM operations. These issues may relate to your organization’s verification of benefits, authorization, or credentialing processes.
Aim for your percentage of receivables over 120 days to be between 12% and 25%, though under 12% is the most ideal. If you have a high percentage of funds coming in past 120 days, further investigation is needed to determine the root causes and identify what changes are necessary.
3. Gross Collection Rate (GCR)
Another key metric is your gross collection rate, measured as a percentage of your total billed charges that are successfully collected in a given time period. This is a vital measure that demonstrates an organization’s financial stability and profitability.
CR BillMax looks at each organization’s GCR at 90, 180, 270, and 365 days post-service. Most organizations only recover 81-85% of what is owed to them, which can significantly impact the financial health of their practice. Outsourcing billing with trusted experts can greatly improve your gross collections rate. CR Billmax customers average a 92% GCR within their first 3 months and 97.4% GCR after their first 12 months.
4. Clean Claims Rate
Lastly, pay attention to your clean claims rate. This metric refers to the percentage of claims that are processed and paid without returns or denials. A high clean claims rate is essential for steady cash flow. When an organization has a low clean claims rate, in addition to lost revenue, they risk increased expenses accrued by their team extending additional time and energy on correcting, reprocessing, and appealing denials.
Generally, an organization with sound pre-RCM operations including comprehensive client intake procedures, credentialing, verification of benefits, and authorization monitoring, is likely to see positive results reflected in its clean claims rate. To achieve clean claims, organizations need to have an effective internal auditing process. While this takes resources and time to complete, it is only a fraction of the time that would be spent resolving returns and denials.
Claim denials affect your revenue collection and disrupt the success and profitability of your business. Download our free Claims Denial Prevention Strategies whitepaper to learn how to become proactive in mitigating denials and better prepare you for your response to them in the event that they occur.
Establish and Maintain Financial Stability
Billing is a complex process. By implementing effective pre-RCM processes and closely monitoring financial KPIs, your organization can establish and maintain financial stability. This, in turn, will enable you to continue providing medically necessary care to children and families in need. It’s vital to recognize the importance of these metrics in supporting the long-term sustainability of your organization’s mission to provide high-quality care. To learn more about how CR BillMax can help you make that happen, book a consultation with our team of experts today.