7 KPI's for Effective Accident Claims Management

Posted by Michael Ford on Aug 25, 2016 3:10:30 PM
Find me on:

Managed correctly, auto-related accident claims yield higher reimbursement rates than most other financial classes. When under-managed, accident claims can expose a hospital to costly compliance risks, lost potential revenue and patient dissatisfaction. Below is a list of KPI’s that should be used to track and manage auto accident claim performance:

Accident Claim KPIs:

Total Number of Auto Accident Claims – The number of auto claims varies by trauma level and hospital size. The goal is to identify 100% of accounts related to auto accidents, and then treat them as a separate financial class

Auto Accident Gross Charges – Accident claims typically represent 1%-2.5% of Gross Patient Revenue

Auto Accident Claim Insurance Leads – In PIP states, leads (i.e. potential payment sources other than health insurance) should be identified for 60%-70% of patients involved in an auto accident. In non-PIP states, leads should be identified for 25%-35% of these patients

Reimbursement from “Non-Health Insurance” Payers – Liability and No-Fault recoveries typically represent >50% of all payment dollars in most states

Reimbursement Rate by Attorney – Best practice hospitals track reimbursement rates for each plaintiff attorney. With visibility, the hospital can negotiate with below-market attorneys from a position of strength

Average Age of Resolved Accounts (Excluding Liability) – In most states, the average age of non-litigated auto claims should be approximately 90 days

Average Age of Resolved Auto-Related Liability Accounts – In most states, the average age of litigated auto claims is typically 11-13 months


While accident claims are extremely complex, employing best practices and tracking performance enables providers to be fully paid for these valuable claims.

Focused. Results.

MRA thought-leaders share specialty reimbursement insights and innovation.

For hospitals and health systems, getting every dollar they're entitled to means focusing on every aspect of their revenue cycle. MRA helps hospitals recognize areas where little changes can yield big results.

Subscribe to Email Updates

Recent Posts

Posts by Topic

Follow Me