This year the Data Science Committee committed to conducting and publishing a regular cadence of surveys. Our goal is twofold: 1) adhere to our charter of gathering benchmarking data for our membership and, 2) engage HBMA members to participate in these surveys. Our initial surveys were intentionally short, and perhaps do not yield the granularity that many might want to see, but on the positive side, we have seen an uptick in participation. The following is a review of the results to date.
SURVEY 1: A/R Ratios
In our first survey, we asked the following questions:
1. What are your Average Days in A/R? (25 responses)
The mean (average) Days in A/R was 42.28
2. What percentage of your A/R is over 90 Days? (25 responses)
Your response gave us this distribution, and the mean percentage of A/R over 90 days was 28.59%
3. What percentage of your A/R is Patient Balance? (24 responses)
Here, the respondents told us that the mean A/R percentage held by patients was 20.95%.
While this is useful, we understand that subsequent surveys will need to have more detail and data to analyze.
SURVEY 2: Collection Ratios and Claims Accuracy
Here we have started to add some more complexity to our questions by differentiating between hospital and office-based RCM activity. In this survey, we asked the following questions:
1. What is your gross collection ratio? (37 responses)
Hospital Based: The mean Gross Collection Percentage (GCP) was 64.67%.
Office Based: The mean Gross Collection Percentage (GCP) was 53.57%.
2. What is your net collection ratio? (37 responses)
Hospital Based: Hospitals averaged 93.22% in Net Collection Percentages.
Office Based: Office based practices, however, had 84.86% as their average NCP.
3. What is your self -pay collection ratio? (36 responses)
Hospital Based: With respect to self-pay collections, hospital-based billers reported 43.67% as the average self-pay collection ratio.
Office Based: Office-based practices reported that their average NCP was 53.83%.
4. What percentage of your claims are accepted by your clearinghouse on the first pass? (38 responses)
Hospital Based: All practices showed a high level of first pass accuracy with hospital-based practices reporting an average First Pass Accuracy rate of 93.22%, while office-based practices reported 94.24% as their average First Pass Accuracy rate.
Office Based
5. What percentage of your claims are paid on the first submission? (38 responses)
Hospital Based: For pure clean claims that were properly and fully adjudicated on the first submission, hospital practices reported an average success rate of 88.33%.
Office Based: Office based practices reported that their clean claims rate averaged 85.69%.
We hope that you find this information interesting and useful. We are hopeful to continue conducting these short benchmarking surveys and have them grow in complexity and participation. Watch for our next survey – coming soon!
