Quality
Maven uses the Six Sigma methodology, primarily DMAIC, in its process to reduce process variations and eliminate defects, which enables physicians to increase their revenue constantly.
Industrial Standard Benchmark of Quality in Billing:
The total accounts receivable in the 0-30 day aging category should not exceed 70 percent of monthly charges.
- The A/R in the 31-60 category should not exceed 15 percent of monthly charges
- The A/R in the 61-90 day category should not exceed 10 percent of charges
- The A/R in the 91-120 day category should not exceed seven percent of charges
- The A/R above 121 days should not exceed 25 percent of monthly charges
Maven achieves the above-mentioned benchmark by identifying the gaps by implementing the appropriate quality tools.
The following factors are determined in Maven for a successful deployment of Six Sigma:
- Top-Down support
- Dedicated Resources
- Employee Incentive
- Business Aptitude
- Essentials of Training
- Project Alignment
- Communication Processes
Steps involved in measuring billing quality for Medical Practice.
Payment Timeliness:
How long does it take to get 50% of your claims paid? Keep in mind that national average is 40 days.
A good quality billing process has a relatively small median, e.g., half of the claims must be paid within 15 days
Completeness of Payment: What is the percent of accounts receivable beyond 30 days, 60 days, and 120 days? The actual amount of Accounts Receivable beyond 120 days is considered uncollectible and labeled as a provider’s loss for write-off
Services
- Medical Transcription
- Medical billing
- Medical coding
- AR Follow up
- Document Management
- Credentialing
- Eligibility Verification
- Referrals
- Medicare RAC audits