KPIs to Watch in Your Urgent Care – Part 2

Wondering what KPIs your urgent care should be on the look out for? We’ve compiled our top ten list for you. Read part one of this blog series to see our top five KPIs first, then dive into our remaining five key performance indicators to watch in your urgent care.

6. Percentage of Accounts Receivable Over 120 Days

What it is and why it’s important: This metric is the percentage of A/R being held for over 120 days. The further out you’re A/R isn’t being collected (in 90 to 120+ days) the more likely it is you have serious collection issues—and lower overall reimbursement rates.

The goal is to have the smallest percentage possible fall into this older aging bucket. Split your A/R into categories of insurance, patient, and employer—and set goals for how much A/R you’d like in each aging segment.

What can affect it: Offenders for insurance delays could be payer contracts, provider credentialing, front desk procedures, or not completing A/R fast enough. You can keep your patient A/R from aging into 120+ days by sending unpaid balances to collections at the 90 day mark.

How to calculate it: Total A/R aged over 120 days / Total A/R

7. Days to Bill

What it is and why it’s important: Days to bill is how long it takes your billing team to get claims submitted. Faster days to bill means fewer days in A/R and faster reimbursement from insurance and patients. However, faster days to bill is not worth claim quality suffering if you increase claim rejections and therefore, days in A/R.

What can affect it: Several items can slow days to bill. They include providers not locking patient charts, front desk errors, slow coding teams, EMR system not set-up to have claims prepared daily, or bad processes for following up on unsent claims.

How to calculate it: Number of days between visit date and claim date to the first payer

(Recommended to calculate only visits with insurance claims.)

8. Days to Pay

What it is and why it’s important: Days to pay is the amount of time it takes a payer to pay a claim. Quicker reimbursement means less days in A/R and faster revenue realized.

What can affect it: This number will vary based on payer types and be affected by how clean your claims are. Contracts with payers generally define days to pay—and appeals for claims can be submitted by billing teams if the claim is rejected or not submitted on time. Ranges for days to pay depend on payer and claim practices, but typically fall in a 7 to 30 day range.

How to calculate it: Number of days between the date when claim is sent and date of first payment received from insurance.

(Recommended to calculate only visits with insurance claims. Break days to pay down by payer. This can identify payers who take longer to pay—so you can pin-point delays and inquire for reasons why.)

9. Visits Per Clinic Per Day

What it is and why it’s important: Even with the best payer contract rates, it doesn’t matter if you don’t have any patients coming through the door. You won’t reach a profit without adequate patient volume. An urgent care business plan should designate break-even and profit points tied to visits per day.

What can affect it: The age and location of the clinic affects this number. Newer clinics slowly build a patient base, while established clinics have a solid base with repeat customers and a reputation of service to rely on. Marketing and community partnerships can also increase this metric. Seasonality will often increase or decrease visits.

How to calculate it: Total patient visits / Total number of business days

(Recommended to calculate over a set time period—generally a week or month. Segment numbers by clinic if you have multiple locations.)

10. Door-to-door Time

What it is and why it’s important: This is the amount of time it takes from the moment a patient enters your clinic to when they leave. In urgent care, lower door-to-door times increase the number of patients you can see. The more efficient the visit time, the more revenue made.

What can affect it: Complexity of visit, staff response within the clinic, and poor workflows can impact this number. Typical door-to-door times in urgent care range from 20 to 70 minutes, well under national emergency room averages.

How to calculate it: Total door-to-door time for all visits / Total visits

(Recommended to calculate over a set time period. You can break down door-to-door time further to see where in the patient visit you can increase efficiencies—such as door-to-provider, exam room, or discharge times.)

Conclusion

Use KPIs to understand your organization’s health. Having set goals for your clinic is essential for success, along with establishing a baseline of data for comparison. Examining data over periods of time gives your clinic a well-rounded picture of performance.

Consistent data review keeps you aware of trends and potential issues. An invaluable asset to your clinic is a reporting tool that lets you pull real-time reports, find clinic trends, and spot trouble areas quickly. Better yet is if this tool includes benchmarks that let you compare your results directly against other urgent cares, regionally and nationally.

Data interpretation requires looking at the entire scope of your clinic’s performance to find correct cause and effect. Assumptions and incorrect comparisons can result in poor reactions and business decisions. KPIs empower better decision making  for urgent care owners—but only if you know how to calculate them, track them, and adjust processes to improve results.

Want all the KPIs we recommend you track? Download the white paper with the ten KPIs to watch for in your urgent care today!

This resource was first published prior to the 2019 merger between DocuTAP and Practice Velocity. The content reflects our legacy brands.