KPIs and Quality Assurance Flashcards

What is the industry benchmark for registration accuracy rate in patient access?

Answer: 97% or above

Industry benchmarks from NAHAM and HFMA target registration accuracy rates of 97% or higher to minimize downstream billing errors.

How is 'days in accounts receivable' (A/R days) affected by patient access performance?

Answer: Registration errors and verification gaps increase A/R days by causing denials and rework

Front-end errors in registration and verification directly increase A/R days through claim denials, rework cycles, and delayed payments.

What is a registration quality audit and how often should it be performed?

Answer: A systematic review of registration accuracy performed at regular intervals, typically monthly or quarterly

Regular registration audits identify error patterns, measure accuracy trends, and provide data for targeted staff coaching and process improvement.

Which KPI measures the percentage of patients whose insurance is verified before their appointment?

Answer: Pre-service verification rate

The pre-service verification rate tracks the percentage of scheduled patients whose insurance eligibility is confirmed before they arrive.

What is the purpose of tracking denial rates by root cause in patient access?

Answer: To identify systemic issues, target training, and implement process improvements that reduce preventable denials

Root cause analysis of denials reveals patterns that drive targeted training, process changes, and technology solutions to prevent recurrence.

How does patient wait time serve as a quality indicator for patient access?

Answer: Wait time reflects staffing adequacy, process efficiency, and directly correlates with patient satisfaction scores

Registration wait times are a key patient experience metric that reflects departmental efficiency and directly impacts overall satisfaction.