Why Your Bank Balance is a Trap: 3 Payment Posting KPIs to Track Today

You log into your bank account. You see a deposit from an insurance payer for $2,000, $20,000, or maybe even $200,000. You feel that hit of dopamine, a sigh of relief, and you think, “Great. The money’s in the bank. I can run payroll, pay the rent, and move on with my life.”

We hate to be the one to break it to you, but that feeling is a trap.

If you don’t know why that money is there, or if it matches exactly what you were promised in your payer contracts, you aren’t actually winning the game of private practice. You’re just guessing with your finances.

Think about it: If you ordered a steak at a restaurant and they brought you a grilled cheese but charged you for the steak, you’d send it back. Yet, we see providers accept the "grilled cheese" from insurance companies every single day because they aren't tracking their Key Performance Indicators (KPIs).

What is a KPI?

In the world of Revenue Cycle Management (RCM), a KPI is a "Key Performance Indicator." Think of it as the scorecard for your practice. It’s a specific metric that tells you if your business is healthy and winning, or if you’re slowly bleeding out while thinking everything is fine.

To master the "territory" of payment posting, there are three specific KPIs you need to start tracking today.

1. Time to Post Payments (The Speed Score)

This is a "stopwatch metric." It measures the time between when you receive the ERA (Electronic Remittance Advice) or EOB (Explanation of Benefits) and the date those payments are actually entered into your system.

Many owners think, "I'm busy, I'll get to it next Friday." But having a high "time to post" is like driving a car at 75 mph with a GPS that’s on a two-week delay. It thinks you're in the driveway, but you're actually on a bridge. If your data is old, your aging reports become total fiction, and you’ll waste hours calling insurance companies for money they already paid you ten days ago.

2. Payment Posting Accuracy (The Precision Score)

This is where you put on your auditor hat. You need to verify that what is in your EHR matches the EOB perfectly—not "close," but down to the penny.

We recommend a simple pass-fail system. Pull 10 claims a week. If there is even a one-cent variance or a missed deductible, that’s a fail. Why? Because "ghost money" destroys patient trust. If you bill a patient $50 because you messed up the math on a contractual adjustment, they won't think it was a simple mistake—they’ll think you’re incompetent.

3. Average Days to Denial Discovery (The Friction Score)

This KPI measures how long it takes from the date of service for a denial to be discovered and recorded.

Insurance contracts have a ticking clock called timely filing. Think of it like a bomb in a movie. If you have 90 days to appeal a claim but you spent 60 of those days "staring at the wall" because you didn't notice the denial, you've only left yourself 30 days to fix it. If that clock runs out, the money is gone forever.

Stop Guessing, Start Tracking

We recently consulted with a practice that wasn't tracking these numbers and found over $1 million in preventable claim denials. Most of that was fixable, but it required a total recalibration of their billing team.

Don't wait until you have a "financial heart attack" to check your practice's blood pressure.

Ready to get your scorecard in order?

If you hate spreadsheets as much as we love them, we’ve already done the heavy lifting for you. You can access our comprehensive Payment Posting KPI Dashboard inside the Hourglass Learning Hub.

Stop hoping for the best and start auditing for accuracy today. Subscribe to the Learning Hub to download your dashboards and take control of your revenue cycle.