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55 – Metric Definitions & Formulas
11 Plays17 days ago
Before we wrap up, let’s take a moment to define the key metrics used throughout this report, along with how each one is calculated. They are listed in the order they appear in the report.
View the full report online: https://www.hstpathways.com/resources/surgery-center-industry-report/
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Transcript
Introduction to Key Metrics
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Before we wrap up, let's take a moment to define the key metrics used throughout this report. Along with how each one is calculated, they are listed in the order they appear in the report. Or block utilization equals the sum of minutes used during a block divided by the sum of minutes blocked.
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Preauthorization
Preauthorization and Insurance Verification
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for all cases equals the distinct count of visits with preauthorization completed divided by the distinct count of visits. Preauthorization completed includes codes P, C, D, and NR.
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Preauthorization when required equals the distinct count of visits with preauthorization completed divided by the distinct count of visits excluding and NR from both the numerator and denominator.
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Insurance
Visit and Appointment Analysis
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verification rate equals the distinct count of visits with insurance divided by the distinct count of visits. Case cancellation rate equals the distinct count of cancelled visits divided by the distinct count of scheduled visits.
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Patient deposit collection rate equals the sum of actual patient deposits collected divided by the sum of expected patient deposits. Turnover time equals the sum of the time between when one procedure ends and the next begins within the same block. OR r duration equals the difference between scheduled appointment time and actual appointment time. On time
Billing and Financial Metrics
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starts equals the average difference between scheduled OR start time and actual OR start time. recovery Time equals the sum of recovery room duration divided by the count of unique visits. Days to bill equals the average difference between date of service and initial bill date.
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Claim denial rate equals the distinct count of visits with a denial divided by the distinct count of visits. Total reimbursement equals the sum of payments divided by the sum of contract fees.
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Patient Bills Unworked Post Date of Service equals the average of today minus the most recent of last note date or date of service. Outstanding Accounts
Revenue and Case Volume Analysis
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Receivable equals the sum of accounts receivable in a given age bucket divided by total accounts receivable across all age buckets.
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Net Revenue per Case equals the sum of contract fees divided by the distinct count of cases. Net Collection Rate equals total payments divided by total contract fees.
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Case Volume equals the average distinct count of visits per month. Case Volume Change equals the distinct count of visits in one time frame divided by the distinct count of visits in another time frame.