1. Category: Appointment Scheduling & Registration Process

Measure: Wait time (days) for next available 
a.  new visit (by clinic and physician)
b. test
c. procedure

2.  Category: Appointment Scheduling & Registration Process

Measure: Provider bumped appointment rates (cancellation and reappointment rate by provider/clinic).

Definition: Scheduled appointment on IDX cancelled, or moved, by provider with less than 22 days notice.

3. Category: Clinic Processes – Visit time

Measure: Average visit, test, or procedure time (Checkout Time lag).

Definition: Data regarding scheduled time, check-in time, scheduled visit duration, and check-out time will be analyzed to determine “standards” and significant deviation from those standards. 

4. Category: Telecommunications

Measure: Percentage of non-abandoned calls answered in 30 seconds and average answer time by time of day and day of week.

Definition:  Percentage of calls answered by a live agent within 30 seconds after any initial recorded message is completed.

5. Category: Telecommunications

Measure: a. Call processing  abandonment rate

Definition: The percentage of callers that “abandon” or hang up before they have entered an ACD queue.
 
Rule Development: NCQA standard is abandonment of 5% or calls or less.

Measure: b. ACD  abandonment rate

Definition: The percentage of callers that “abandon” or hang up after navigating initial call processing and are waiting in an ACD queue.
 
Rule Development: NCQA standard is abandonment of 5% or calls or less.

6. Category: Volume/Productivity

Measure: New patients per provider (physician/module or unit/division/dept) per defined unit (4-hour clinic sessions/month/quarter).

Definition: New patient can be:
a. new  to provider
b. new to practice

7. Category: Volume/Productivity

Measure: Total patient volume per room, per provider, per session
(new patient  to provider & follow-up with provider).

8. Category: Volume/Productivity

Measure: Medicare “relative value units”.

9. Category: Volume/Productivity

Measure: Visits per FTE.

10. Category: Financial

Measure: Percent of invoices failing edit screen, requiring rework by clinic or department.

11. Category: Financial

Measure: Percent of invoices paid correctly after 1st  submission to payer.

12. Category: Financial

Measure: Timely submission of invoices.
 

13. Category: Financial

Measure: Days in accounts receivable.

14. Category: Financial

Measure: Reimbursement rates.