One Position Every Health Provider Should Fill: Director of Assurance

Quality metrics are becoming more important than ever in healthcare, particularly in outcome-based reimbursement models. These models reward quality of care, but only if you have the data to prove it. For physicians who are trying to keep up with charting requirements and electronic health record changes, tracking quality data may be too much.

In fact, measuring quality can be a full time job. That’s why, with higher reimbursements on the line, behavioral health facilities should consider hiring a Director of Assurance.

What Does a Director of Assurance Do?

A director of assurance monitors quality metrics and revenue cycle statistics that serve as Key Performance Indicators. Their job should be to assure that you have all the financial and patient care data you need to actively work toward higher reimbursement with all payors.

In revenue cycle management, a director of assurance should monitor key statistics such as:

• Average days in accounts receivable

• Percentage of total revenue over 60 days old

• Claim denials

• Percentage of total revenue from each insurance provider

This data helps you to adjust priorities to improve reimbursement. It can include anything from increasing follow-up, improving procedures for collecting patient data, payor outreach for increased referrals from a specific payor, and so on.

The Director of Assurance should also collect important practice data like:

• What services are utilized most often

• Average number of days authorized per level of care

• Average length of patient stay

• Number of patients who leave against medical advice

Again, this data helps set priorities for improvement. How can you get more days authorized? What services may need expanded? Are your patients staying in treatment for the recommended time or are they leaving against medical advice? By tracking these Key Performance Indicators, you can make strategic changes to your service model that improve your revenue while also improving patient care.

An Alternative to Director of Assurance

If you aren’t in a position to hire a new full-time staff member, you can still track this important data with help from Datapro billing services. Our advanced software tracks all of these metrics, making it easy for you to analyze and collect data. We also offer hands-on support to help you optimize your practice with quality metric tracking. Contact us today at 805-579-3537 or fill out our online form to schedule your consultation.