Better Insight Into Revenue Cycle Tasks Can Transform These Roles and Patient Experiences

While 84% of healthcare revenue cycle teams use productivity standards or quotas to meet goals, healthcare leaders are often lacking insight into how long revenue cycle tasks can take. A new report from AKASA uses proprietary data as well as surveys to identify the average time it takes health system staff to complete critical tasks within revenue cycle operations.

The benchmarks included in the report, like financial clearance, billing, and denials, are some of the first for the revenue cycle industry and accurately forecast how to measure productivity for tasks within the focus areas. The survey gathered responses from around 400 chief financial officers and revenue cycle leaders at hospitals and health systems across the United States from May to June 2021 as part of the Healthcare Financial Management Association’s Pulse Survey.

Of the 84% who reported using productivity measures, nearly 70% scaled these across all focus areas within the revenue cycle, including claims management, insurance follow-up, coding, denials management, and financial clearance.

Having accurate benchmarks not only provides leaders with information on a reasonable number of claims or tasks that can be worked on daily for the purposes of staffing and resource needs, but also allows managers to set goals.

“It’s challenging for healthcare revenue cycle leaders to access accurate benchmarks in terms of actual staff productivity,” Amy Raymond, head of revenue cycle operations at AKASA, said in a statement. “You often can’t pull productivity metrics on someone working eligibility, for example, because it often gets mixed in with other things that they’re doing at the same time.”

Information about how long tasks take can also help healthcare organizations identify areas where they might invest in automation to remove time-consuming, repetitive, and laborious tasks from staff members.

Tools and processes, such as automation, have been developed to help revenue cycle staff. Automating time-consuming and repetitive tasks that are essential, but a less strategic use of staff time and talent, can help organizations improve retention in three ways:

• Employees now have time to focus on more complex responsibilities and roles
• Revenue cycle leaders can develop specialized teams that focus on patient-facing roles that improve the overall patient financial experience
• Team members that manage automation efforts build valuable skills that can be utilized to lead other initiatives as organizations expand digital transformation efforts

The area where the fewest respondents said they use productivity standards or quotas was financial clearance (8%). More than 15% said they use standards or quotas for denials management (17%), insurance follow up (20%) and claims management (23%). However, two-thirds (67%) said they use standards and quotas in all areas.

The report included a list of tasks and the average time it takes for a person to perform the task. The most time-consuming tasks were:

• Prior authorization (12 minutes and seven seconds): the process includes initiating requests and checking the daily status of requests
• Appeal submission (10 minutes and 18 seconds): the process of submitting an appeal to payers to challenge a denied claim includes providing additional information, fixing errors or crafting arguments to support an appeal
• Information requested by a payer (10 minutes and 15 seconds): this process requires the collection and collation of payer-request information to get a claim processed

The task that takes the least amount of time on average is price estimation. It takes an average of five minutes and 12 second to calculate an estimated price amount a patient will be responsible to pay for an anticipated service.