rcm metrics

Account Reconciliation Rate

Accelerate your revenue cycle

Boost patient experience and your bottom line by automating patient cost estimates, payer underpayment detection, and contract optimization in one place.

Get a Demo

What is Account Reconciliation Rate

Account Reconciliation Rate is a key metric in healthcare revenue cycle management that measures the percentage of accounts that have been reconciled or balanced against the expected payment amount. This metric is important because it helps healthcare organizations identify discrepancies or errors in their billing and payment processes, which can lead to lost revenue and increased costs. A high Account Reconciliation Rate indicates that a healthcare organization is effectively managing their revenue cycle and minimizing the risk of lost revenue due to billing errors or discrepancies. On the other hand, a low Account Reconciliation Rate may indicate that there are issues with the organization's billing and payment processes that need to be addressed. Overall, tracking Account Reconciliation Rate is an important part of healthcare revenue cycle management, as it helps organizations ensure that they are maximizing revenue and minimizing costs by identifying and addressing billing errors and discrepancies.

How to calculate Account Reconciliation Rate

Account Reconciliation Rate is calculated by dividing the number of accounts reconciled by the total number of accounts in a given period and multiplying the result by 100.

The formula for calculating Account Reconciliation Rate is: (Accounts Reconciled / Total Accounts) x 100

For example, if a healthcare organization has 10,000 patient accounts and reconciles 9,000 of them in a month, the Account Reconciliation Rate would be: (9,000 / 10,000) x 100 = 90%

This means that the organization has reconciled 90% of its patient accounts in the given period. A high Account Reconciliation Rate indicates that the organization is effectively managing its revenue cycle and ensuring that all patient accounts are accurate and up-to-date. A low Account Reconciliation Rate may indicate inefficiencies in the revenue cycle process and potential revenue loss.

Best practices to improve Account Reconciliation Rate

Best practices to improve Account Reconciliation Rate are:

1. Regularly Monitor and Analyze Reconciliation Reports: It is essential to regularly monitor and analyze reconciliation reports to identify discrepancies and errors. This will help in identifying the root cause of the problem and taking corrective actions.

2. Implement Automated Reconciliation Processes: Implementing automated reconciliation processes can help in reducing errors and discrepancies. Automation can also help in improving the speed and accuracy of the reconciliation process.

3. Ensure Timely and Accurate Posting of Transactions: Timely and accurate posting of transactions is critical to maintaining a high account reconciliation rate. It is essential to ensure that all transactions are posted accurately and in a timely manner.

4. Conduct Regular Staff Training: Conducting regular staff training can help in improving the skills and knowledge of the staff responsible for the reconciliation process. This can help in reducing errors and improving the overall efficiency of the process.

5. Implement Quality Control Measures: Implementing quality control measures can help in identifying errors and discrepancies before they become a problem. This can help in improving the accuracy and efficiency of the reconciliation process.

6. Use Technology to Improve the Reconciliation Process: Using technology can help in improving the reconciliation process. For example, using software that automatically matches transactions can help in reducing errors and improving the speed of the process.

7. Establish Clear Policies and Procedures: Establishing clear policies and procedures can help in ensuring that the reconciliation process is consistent and efficient. This can help in reducing errors and improving the overall efficiency of the process.

Account Reconciliation Rate Benchmark

The industry standard benchmark for Account Reconciliation Rate is typically set at 95% or higher. This means that the healthcare organization should be able to reconcile at least 95% of its accounts accurately and completely. The remaining 5% or less may include accounts that are still in the process of being reconciled or those that require further investigation. To calculate the Account Reconciliation Rate, the healthcare organization must compare the total number of accounts that have been reconciled to the total number of accounts that require reconciliation. This calculation should be performed on a regular basis, such as monthly or quarterly, to ensure that the organization is meeting its benchmark and to identify any trends or issues that may require attention. A high Account Reconciliation Rate indicates that the healthcare organization has a strong billing and collection process in place, which can lead to improved cash flow and financial stability. On the other hand, a low Account Reconciliation Rate may indicate that there are issues with the organization's billing and collection processes, such as inaccurate coding or incomplete documentation, which can lead to lost revenue and increased costs. In conclusion, the industry standard benchmark for Account Reconciliation Rate is 95% or higher, and healthcare organizations should regularly monitor this metric to ensure that they are meeting this benchmark and to identify areas for improvement in their billing and collection processes.

How MD Clarity can help you optimize Account Reconciliation Rate

Revenue cycle software can significantly improve the Account Reconciliation Rate metric by automating the process of reconciling accounts. With the help of advanced algorithms and machine learning, revenue cycle software can quickly identify discrepancies between the expected and actual payments, and reconcile them in real-time. This not only saves time and effort but also reduces the chances of errors and inaccuracies. Moreover, revenue cycle software can also provide real-time visibility into the revenue cycle, allowing healthcare providers to monitor the performance of their billing and collections processes. This helps them identify bottlenecks and inefficiencies, and take corrective actions to improve the overall revenue cycle performance. If you're looking to improve your Account Reconciliation Rate metric and optimize your revenue cycle management, it's time to consider revenue cycle software. Book a demo with MD Clarity today to see firsthand how our revenue cycle software can help you achieve your revenue cycle goals.

Improve your financial performance while providing a more transparent patient experience

Full Page Background