Final answer:
Two key KPIs for monitoring A/R related to claim production and submission are the Claim Denial Rate, which reflects the number of claims rejected by payers, and Days in Accounts Receivable, indicating the average collection time after service delivery.
Step-by-step explanation:
In the context of healthcare finance, Key Performance Indicators (KPIs) are crucial for monitoring the efficiency and effectiveness of the billing processes related to accounts receivable (A/R). When it comes to the production and submission of claims to third-party payers and self-pay patients, two prominent KPIs are the Claim Denial Rate and the Days in Accounts Receivable (also known as Days Sales Outstanding).
The Claim Denial Rate quantifies the percentage of claims that are rejected by payers. A high denial rate can indicate issues in claim submission processes, such as errors in patient information, coding mistakes, or inadequate documentation. Reducing the claim denial rate is essential to improving cash flow and minimizing the time and resources spent on reworking claims.
On the other hand, the Days in Accounts Receivable metric measures the average number of days it takes to collect payment after a service has been rendered. This indicator reflects the overall efficiency of the billing process, from claim submission to payment receipt, and a lower number is generally preferred, indicating faster collection times.