Keystone recognizes medical billing is a complex business fraught with hazards that can negatively impact revenue, compliance and patient satisfaction if not managed carefully. For this reason we have developed a robust quality monitoring and reporting structure that allows executives to easily monitor key performance indicators (KPIs) that measure the health of the revenue cycle. These KPIs assure, at a minimum:
- 100% of billable patient encounters are captured in the billing system.
- Provider documentation is accurately translated into ICD-10 and CPT codes, with any documentation weaknesses funneled back to providers.
- Claims are billed to payers accurately and timely.
- Payments are posted daily and allotted accurately.
- Denied or rejected claims are addressed quickly.
- Patients receive statements only for the portion of the claim that is their responsibility.
- Patient phone calls are answered within 30 seconds, and our Patient Advocates deliver accurate, helpful information with a high degree of empathy and support.
- Patient complaints are resolved quickly and satisfactorily.
To assure continuous quality and compliance, Keystone contracts with various outside consultants and auditors to test revenue cycle systems and assure we meet or exceed compliance standards. We also employ an experienced team of provider documentation educators that works tirelessly with providers and medical coders to achieve the quality standards set by CMS programs such as MACRA/MIPS (aka PQRS).