Billing Quality & Transparency
Billing Quality is measured in terms of timeliness and completeness of payment. The shape of the distribution curve of Accounts Receivable illustrates billing quality. Specific measures include median and percent of accounts receivable beyond 30 days, 60 days, and 120 days. A good quality billing process has relatively small median, e.g., half of the claims must be paid within 30 days, and a steep drop in terms of percents of accounts receivable, e.g., reaching less than 10% of A/R beyond 120 days. The actual amount of Accounts Receivable beyond 120 days is considered uncollectable and labeled as a provider's loss for write off.
Billing Transparency allows every participant in the billing process to see continuously both its big picture and the minute detail. The big picture consists of total cash flow in a given time period, current submitted and failed claims, and Billing Quality. The minute detail pertains to individual claims making up the big picture, including complete history from the moment of creating the claim, testing its validity, corrections, submissions, and reconciliation, until payment.
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