EPISODE SUMMARY
In this domain-specific deep dive, Jeremy explains why tracking metrics for eligibility and benefits (E&B) is the secret weapon of a proactive practice. Many providers view E&B as a "time suck," but without clear KPIs, you’re flying blind. Jeremy breaks down three essential metrics—Time to Completion, Accuracy Rate, and Call Time Logs—to help you identify which payers are dragging their feet and which staff members might need a little extra support. The goal is simple: ensure your patients never walk through the door without knowing exactly what they owe, preserving both your trust and your bottom line.
KEYWORDS
Revenue Cycle Management, Private Practice, Medical Billing, Insurance Eligibility, Practice Management, KPIs, Patient Trust, Healthcare Finance
TAKEAWAYS
The Cost of Lost Trust: When a patient receives an unexpected bill, trust leaves your practice, and revenue usually follows right behind it.
Move from Reactive to Proactive: Tracking metrics helps you catch "carve-outs" (where a payer subcontracts benefits) before they turn into denials downstream.
Efficiency vs. Accuracy: It’s not just about how fast you do it; it’s about getting the right information the first time so your billing team isn't ripping their hair out later.
Identify Payers of Concern: Use data to decide if a specific insurance company’s low reimbursement rate is worth the administrative headache of their "Byzantine" phone systems.
The Power of Time Studies: Tracking call times for just two weeks can reveal which payers offer efficient portals and which ones are wasting your staff’s time.
CHAPTERS
00:00 Introduction: Protecting Patient Trust Through Better Eligibility Metrics
03:42 Managing Time and Cost Through Eligibility Metrics
06:36 Key Performance Indicators for Eligibility and Benefits
13:50 The Trust Metric: Measuring Eligibility & Benefits Accuracy
17:24 The Final KPI: Eligibility & Benefits Call Time
19:36 The Eligibility & Benefit KPI Dashboard
20:53 Conclusion: Building a Stronger Revenue Cycle Through Metrics
RESOURCES
Today Sponsors: Blueprint
Learn More About The Claim Game: Visitpracticesol.com/podcast
The Hourglass Learning Hub: Dive deeper into RCM best practices and downloadable tools mentioned in this episode, like the various checklists and templates, by visitingThe Hourglass Learning Hub.
Our Blog: Explore years of educational articles on billing and practice management atPractice Solutions Blog.
Book: For a comprehensive guide on navigating insurance, grab your copy of Insurance Billing Basics: Steps for Therapists to Successfully Take Insurance.
Images: Eligibility & Benefit KPI Dashboard
