"SMART" Year End Revenue Cycle Goals

Posted by Ben Castleberry on Aug 3, 2018 10:06:00 AM

2018 is more than halfway over. "Finishing Strong" will start to be a common message through out organizations all over the country. Goals will be set, measured, and some will be met, some will be exceeded and most will fail. What makes a medical coding goal setting (1)good goal. What goals should you be setting for your revenue cycle and your medical coding? 

2018 is more than halfway over. "Finish Strong" will start to be a common message throughout organizations all over the country. Goals will be set, measured, and some will be met, some will be exceeded...Most will fail. What makes a good goal? What goals should you be setting for your revenue cycle? 

Before we get into specific goals, lets quickly what sets apart the structure of a good goal versus the structure of a poorly set goal. We call them "SMART" Goals. Specific, Measurable, Attainable, Relevant, and Time-Bound. 

Specific - In terms of revenue cycle and medical coding, you should choose the particular metric you want to improve, like coding related denials, Days in AR, or Overall Medical Coding reimbursement revenue. You should also identify the team members working towards the goal, the resources they’ll have, and their plan of action.

Measurable - If you want to gauge your team’s progress, you need to quantify your goals, like achieving an X percentage increase in Denials, AR, or Reimbursement.

Attainable - Make sure that X-percentage increase is rooted in reality. If your medical coding related denials decreased by 1% last month, try to decrease it by 3-5% this month, not 25%. It’s crucial to base your goals off of your own analytics, not industry benchmarks, or else you might bite off more than you can chew and burn out.

Relevant - Your goal needs to relate to your organization's overall goal and account for current trends in your industry. For instance, will growing your Facebook following lead to more revenue? And is it actually possible for you to significantly boost your organic reach on Facebook after their most recent algorithm change? If you’re aware of these factors, you’ll be more likely to set goals that are realistic, achievable, and beneficial to your company.

Time-bound - Attaching deadlines to your goals puts pressure on your team to accomplish them. And this helps you make consistent and significant progress in the long-term. If you don’t give yourself a deadline, accomplishing your goal will take too long to achieve long-term success. For example, what would you prefer? Increasing leads by 5% every month, leading to a 30-35% increase in half a year? Or trying to increase leads by 15% with no deadline and achieving that goal in the same time frame?


Now you know how to set SMART goals, let's actually give an example of a SMART medical coding or healthcare revenue cycle goal you can set and implement today! 



Have a healthy Accounts Receivable is something every organization strives for. However, making your goal "Have a Healthy AR" is not SMART by any stretch of the imagination. So, if we want to have a healthy AR, what does that mean? What are some specific things that impact the health of our AR? Coding, billing, denials, insurance, etc. So a better goal to help increase the health of our organizations AR would be something like. Submit new claims within 48 hours of patient discharge over the next 90 days. This should help the amount of days in AR. After 90 days you can look and see if the AR days have decreased and what percentage that has done. 


Last but not least, make sure your team is involved in the goal setting process, and get their buy in. If they do accomplish their goals, perhaps it makes sense to reward them with something. Be it a financial reward, or even something as small as an ice cream cone, I am sure they will grateful for accomplishing the goal and the intrinsic rewards that brings! 


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Topics: Medical Coding Services, medical audits, ICD-10, medical coding, payment posting, Medical Coding Compliance