Question: Question Using the provided revenue-cycle dashboard LISTED BELOW - analyze the data in the dashboard to determine whether the organization is meeting its KPIs. Then
Question
Using the provided revenue-cycle dashboard LISTED BELOW - analyze the data in the dashboard to determine whether the organization is meeting its KPIs. Then write an executive summary discussing your analysis.
The following is a dashboard for a hypothetical hospital. It includes key performance indicators for the front end, middle, and back end of the revenue cycle. Use the data in this dashboard to support your work on the Module Seven Activity.
PLEASE USE THE revenue-cycle dashboard TABLE BELOW FOR THIS ASSIGNMENT
| Area of the Cycle | Key Performance Indicator (KPI) Target: 100% | January - March Actual | April - June Actual | July - September Actual | October - December Actual |
| Front End | Accurate patient demographics (correct spelling of name, middle initial, address, phone number, date of birth) are collected at registration. | 89% (Color: Yellow) | 87% (Color: Yellow) | 92% (Color: Yellow) | 92% (Color: Yellow) |
| Insurance is verified and insurance card is scanned or copied upon initial visit or admission. | 71% (Color: Red) | 68% (Color: Red) | 92% (Color: Yellow) | 75% (Color: Red) | |
| Required prior authorizations are obtained before procedures are scheduled. | 98% (Color: Green) | 99% (Color: Green) | 89% (Color: Yellow) | 85% (Color: Yellow) | |
| Patients without insurance or potential high out-of-pocket costs will be provided information about the organizations financial assistance program at the time of registration. | 48% (Color: Red) | 32% (Color: Red) | 30% (Color: Red) | 51% (Color: Red) | |
| Middle | Charges are captured for services provided. | 91% (Color: Yellow) | 92% (Color: Yellow) | 85% (Color: Yellow) | 86% (Color: Yellow) |
| Clinical documentation is completed within 5 days of patient visit/discharge. | 93% (Color: Green) | 96% (Color: Green) | 81% (Color: Yellow) | 81% (Color: Yellow) |
| Area of the Cycle | Key Performance Indicator (KPI) Target: 100% | January - March Actual | April - June Actual | July - September Actual | October - December Actual |
| Members of the medical staff are notified within 2 days of any delinquent (greater than 5 days) clinical documentation in patient charts. | 100% (Color: Green) | 98% (Color: Green) | 99% (Color: Green) | 100% (Color: Green) | |
| Coding is completed within 5 days of clinical documentation completion in the medical record. | 100% (Color: Green) | 70% (Color: Red) | 78% (Color: Red) | 76% (Color: Red) | |
| Back End | Claims will be scrubbed for errors using electronic scrubbing software prior to submission to a third-party payer. | 100% (Color: Green) | 98% (Color: Green) | 100% (Color: Green) | 100% (Color: Green) |
| Denied claims are reviewed/accepted/appealed within 21 days of claims denial. | 62% (Color: Red) | 53% (Color: Red) | 59% (Color: Red) | 59% (Color: Red) | |
| Patients will be billed for any account balance within 14 days of insurance reimbursement. | 88% (Color: Yellow) | 95% (Color: Green) | 96% (Color: Green) | 95% (Color: Green) | |
| Days in accounts receivable will be less than 47 days at the end of any quarter. | 56 days (Color: Red) | 48 days (Color: Red) | 55 days (Color: Red) | 53 days (Color: Red) |
The following table explains the color-coding system in the dashboard above:
| Meeting Requirements 95% or Greater | Green |
| Meeting Requirements 80% to 94% | Yellow |
| Meeting Requirements Less Than 80% | Red |
Your executive summary should have short paragraphs for each rubric criterion, with clearly marked paragraph headers.
Specifically, you must address the following rubric criteria:
- Revenue-Cycle Dashboard: Summarize at least two KPIs from the front end, two from the middle, and two from the back end of the revenue cycle, as well as why you believe these KPIs will demonstrate whether the organization is meeting its KPIs or not.
- Front-End KPIs: Examine the possible cash-flow issues and operational improvement possibilities of at least two front-end KPIs in the revenue-cycle dashboard of the chosen organization. Consider the following questions to guide your response:
- How would you define the KPIs you identified from the front end?
- How would these KPIs inform the organization of potential future cash flow issues?
- How do the KPIs inform the organization of operational-improvement opportunities?
- Middle KPIs: Examine the possible cash-flow issues and operational improvement possibilities of at least two KPIs from the middle of the revenue-cycle dashboard of the chosen organization. Refer to the guiding questions for the Front-End KPIs in number 2 above for additional guidance.
- Back-End KPIs: Examine the possible cash-flow issues and operational improvement possibilities of at least two KPIs from the back end of the revenue-cycle dashboard of the chosen organization. Refer to the guiding questions for the Front-End KPIs in number 2 above for additional guidance.
- Metrics Analysis: Analyze the metrics on the dashboard to determine whether the organization is meeting its KPIs or not. Consider the following questions to guide your response:
- How is the dashboard notifying the leader if any metrics are not being met?
- How would you determine that the metrics are not being met if the dashboard had no visual cues?
All the claims in your deliverable should be evidence based. Your citations should be from your independent search for evidence (not from the textbook, or module resources) of credible sources and be current within the last five years.
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