Account Resolution Rate

Account Resolution Rate is a key metric in healthcare revenue cycle management that measures the percentage of accounts that have been resolved or closed within a specific period of time. This metric is used to evaluate the effectiveness of the revenue cycle management process in terms of timely and accurate billing, collections, and account follow-up. A high account resolution rate indicates that the revenue cycle management process is efficient and effective, while a low rate may indicate issues with billing accuracy, collections, or follow-up. It is important for healthcare organizations to monitor their account resolution rate regularly to identify areas for improvement and ensure that they are maximizing revenue and minimizing revenue cycle inefficiencies.

Account Resolution Rate is calculated by dividing the total number of accounts resolved by the total number of accounts worked during a specific period of time.

The formula for calculating Account Resolution Rate is: (Accounts Resolved / Total Accounts Worked) x 100

For example, if a healthcare organization worked on 1,000 accounts in a month and resolved 800 of them, the Account Resolution Rate would be: (800 / 1,000) x 100 = 80%

This means that 80% of the accounts worked on during that month were successfully resolved. The Account Resolution Rate is an important metric in healthcare revenue cycle management as it measures the efficiency and effectiveness of the organization's efforts to resolve outstanding accounts. A high Account Resolution Rate indicates that the organization is effectively managing its revenue cycle and collecting payments in a timely manner.

Best practices to improve Account Resolution Rate are:

1. Accurate and Timely Documentation: Ensure that all patient information, including insurance details, is accurately documented in the system. This will help in reducing claim denials and rejections, which can delay the account resolution process.

2. Regular Follow-up: Regular follow-up with insurance companies and patients is crucial to ensure that claims are processed and paid on time. This will help in reducing the number of outstanding accounts and improve the account resolution rate.

3. Use of Technology: Implementing technology solutions such as automated billing and payment systems can help in streamlining the account resolution process. This will reduce the time and effort required to manage accounts, resulting in improved account resolution rates.

4. Staff Training: Ensure that staff members are trained on the latest billing and coding practices, as well as on the use of technology solutions. This will help in reducing errors and improving the efficiency of the account resolution process.

5. Performance Monitoring: Regularly monitor the performance of the account resolution process and identify areas for improvement. This will help in identifying bottlenecks and implementing corrective measures to improve the account resolution rate.

6. Patient Education: Educate patients on their insurance coverage and the billing process. This will help in reducing the number of denied claims and improving the account resolution rate. By implementing these best practices, healthcare organizations can improve their account resolution rate, reduce the number of outstanding accounts, and improve their overall revenue cycle management.

The industry standard benchmark for Account Resolution Rate is typically set at 90% or higher. This benchmark is essential because it indicates the effectiveness of the healthcare organization's revenue cycle management process in collecting payments from patients and insurance companies. A high Account Resolution Rate means that the organization is efficiently managing its accounts receivable and collecting payments in a timely manner. To calculate the Account Resolution Rate, the total number of accounts resolved or paid in full within a specific period is divided by the total number of accounts that were outstanding at the beginning of that period. The resulting percentage is the Account Resolution Rate. It is important to note that the benchmark for Account Resolution Rate may vary depending on the size and type of healthcare organization. For example, a smaller healthcare organization may have a higher benchmark than a larger organization due to differences in resources and patient volume. In conclusion, the industry standard benchmark for Account Resolution Rate is 90% or higher. This metric is crucial in measuring the effectiveness of healthcare revenue cycle management and ensuring that the organization is collecting payments in a timely manner.

Revenue cycle software can significantly improve the Account Resolution Rate metric by streamlining the entire revenue cycle process. With the help of advanced analytics and automation tools, revenue cycle software can identify the root cause of payment delays and denials, and provide actionable insights to resolve them quickly. By automating the claims submission process, revenue cycle software can reduce errors and ensure that claims are submitted accurately and on time. This can significantly reduce the number of denied claims and improve the overall Account Resolution Rate metric. Additionally, revenue cycle software can provide real-time visibility into the status of claims, allowing healthcare providers to proactively identify and resolve issues before they become a problem. This can help to reduce the time it takes to resolve outstanding accounts and improve the overall efficiency of the revenue cycle process. If you're interested in seeing firsthand how revenue cycle software can improve your Account Resolution Rate metric, we invite you to book a demo with MD Clarity. Our revenue cycle software is designed to help healthcare providers optimize their revenue cycle process and improve their financial performance. Contact us today to learn more!