Front-end and submission KPIs
KPIs should tie to actions. A metric without an owner and cadence rarely changes behavior.
- Eligibility verification completion rate for scheduled visits
- Charge lag (days from date of service to claim submission)
- First-pass acceptance or clean claim proxy (define consistently)
Denial and rework KPIs
Track denial rate by category—eligibility, coding, authorization, timely filing—not only a single headline percent.
Appeal turnaround time and resubmission success by category may help prioritize training topics.
AR and cash application KPIs
Days in AR by payer, unapplied payment balance, and posting lag provide cash application visibility.
Report snapshots should be designed for coaching conversations, not guaranteed financial outcomes.