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4 Impactful Medical Billing Reports for a Profitable Practice

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Medical Billing Reports help a physician to understand the financial health and the business side of the practice. The reports clearly show the different revenue cycle metrics, which indicate the areas of concern needing corrective action and the areas where revenue can be increased. Whether revenue comes from payors or patients, medical reports help a practice stay profitable while delivering excellent patient care.

Listed below are four impactful reports that will help a physician monitor the practice’s financial health and not leave money on the table.

  1. 1. Accounts Receivable Aging Report

The AR Aging report helps a physician to have an overall picture of the practice. Looking at the report, an expert biller can tell whether the billing department is doing a good job. The report can be generated by most medical billing software.

This report shows claims based on the number of days they are unpaid. Most claims take about a month to be paid. So this report gives a bird’ eye view of pending claims, while detailed follow-up reports help analyze causes for the delay in reimbursement/payment.

Claims remaining unpaid for longer than 45 days need to be looked into and followed up, whereas those pending for more than 90 days need urgent action as payors have filing deadlines.

It is also to be noted that paper claims take a longer time to be processed than claims submitted electronically. Also, claims relating to worker’s compensation, accidents, and out-of-state payors take more extended processing periods.

  1. 2. Key Performance Indicators Report

This report is a vital one that identifies the key metrics in the practice’s revenue cycle, helping the physician set goals and measure progress against those goals. The billing software can generate these reports saving valuable time and practices can see data in real-time.

Generating this report every week will give an uninterrupted view of the performance of the billing department. It can also help identify any problems in the claims process. Equally important, the report will show which services and CPT codes are the most profitable for the practice.

KPI reports can monitor a range of information, including:

  • Total encounters
  • Total number of procedures
  • Total charges
  • Total collections
  • Outstanding A/R
  • Total adjustments

This report allows billers to study various indicators from month to month and identify both positive and negative trends. Such a process enables practices to keep doing what’s working, improve processes and change what is not working.

Looking into the aspect of collections, if the practice has relatively steady charges, then collections should be reasonably constant. If the charges have been increasing, the collections should too.

Any striking and unexpected change in total collections is a red flag, such as a sudden drop in collections that have generally been steady. Also, if charges have been increased in a month, but collections have not increased the following month, this is an area of concern.

  1. 3. Top Payor/Insurance Analysis Report

This report provides vital information about payors, which can help a practice make important choices about revenue. It tracks revenue cycle metrics such as charges, payments and collections and shows the top ten payors contributing the most to the practice. The report also tracks payments, collections, and CPT codes and units, thus allowing the practice to study the charges, payments, and collections for a specific CPT code.

It also tracks the Collection per Total Relative Value Unit (RVU), which gives information about rates and how the physician is getting paid for specific procedures. The Insurance Analysis report provides the information a physician needs to negotiate better pricing with insurance companies.

Claims are submitted using CPT codes for the procedures completed, and every CPT code has a total RVU assigned to it. This RVU helps determine how much a practice is paid for each of the services rendered. By looking at the Collection Per Total RVU rate for given procedures, a physician can gauge how good the practice’s rates are, how it is getting paid for specific procedures, and how the revenue cycle is performing.

In the Top Payor/Insurance Analysis Report, it is understood that all of the top commercial carriers must have a Collection Per Total RVU that is higher than the current Medicare Conversion Factor. A physician would also like to see all top commercial payors with very similar Collection Per Total RVU rates.

Suppose the report shows Collection Per Total RVU rates for the top payors lower than Medicare rates or a wide variation in the Collection Per Total RVU rates among the top payors. In that case, the physician can consider renegotiating the contract with payors.

  1. 4. Patient Payment Report

Patient payments are an area of the revenue cycle that needs to be checked often. Out-of-pocket expenses by patients are on the rise due to various factors. The front office faces challenges in collecting payments from patients, especially if the bill is high.

Hence generating reports on the status of patient payments and monitoring the same is needed to keep the practice profitable.

The above reports are essential for a practice to take action to remain financially healthy. Every practice may not have the resources to generate reports frequently. Not to worry! Bristol Healthcare Services, a medical billing company with more than two decades of experience, is here for you. We provide collection reports, impact analysis, revenue analytics, and key indicators so that a practice can reduce insurance company denials, increase reimbursement average, and remain financially sound.

Allow us to help you take your practice to the next level!

Talk to an expert today!