Essential Medical Billing Reports
Medical billing reports show you how your practice is performing on important revenue cycle metrics, whether claims are being paid in a timely fashion, and how well insurance carriers are paying you for key procedures. Depending upon medical specialty and size of practice, there are different formats of medical billing reports. In this article, we discussed the top three essential medical billing reports which you should have to track the financial health of your practice.
Accounts Receivable Aging Report
The Accounts Receivable (AR) aging report helps in measuring the overall financial health of a practice. By looking at this report, you can tell whether your practice’s billing department is doing a good job or not. The AR aging report breaks down claims based on the number of days they’ve been in receivables (or the number of days they’ve been unpaid). Most claims take an average of about a month to get paid. This report allows you to identify potential issues from a high-level view, while the follow-up reports give you a close-up look at what issues might be causing delays in payment.
In the AR aging report, an ideal result would be to see that all claims are being paid within 45 days. There might be a problem if a claim hasn’t been either paid or rejected by this time, so if you’re seeing claims stuck in receivables for more than 45 days, it’s worth following upon. Aging over 90 days is an even bigger red flag. At this point, it’s crucial for your practice to get the claim handled, as unpaid claims could interfere with insurance companies’ timely filing deadlines.
On the other hand, there’s not necessarily a need to panic if you see one or two claims taking longer to process. A lot of factors can affect this report, such as your practice’s patient population and the amount of paper and electronic claims being submitted. Likewise, claims from workers’ compensation, automobile accidents, and out-of-state insurance carriers generally take longer to process. A high volume of paper claims can also result in longer processing times; the average paper claim takes about a month to process, while electronic claims are frequently processed in as little as two weeks.
Key Performance Indicators (KPI) Report
KPI reports can track a variety of information, including total encounters, the total number of procedures, total charges, total collections, outstanding AR, and total adjustments. Running this report once a week on average will give you an uninterrupted view of your billing performance. In the Key Performance Indicators report, naturally, you want to see steady or positive trends in your top indicators. If you have relatively steady charges, your collections should be relatively steady as well. If your charges have been increasing, your collections should too. If you’ve identified potential problem areas and have been working towards, for example, increasing overall collections, you’re looking for evidence that your work is paying off. A red flag in the KPI report is any dramatic and unexpected change in total collections. For example, a sudden drop in collections that have historically been consistent could indicate a problem. And if charges increase one month, but collections don’t increase the following month, this might mean trouble, as well.
Top Insurance Analysis Report
The top carrier/insurance analysis report tracks the charges, payments, and collections of your practice’s top 10 carriers/insurance i.e., the payers and insurance companies that make up the majority of your practice’s business. The report tracks payments, collections, and CPT codes and units, allowing the practice to drill down into the charges, payments, and collections for a specific CPT code. This report also provides important information practices that can use to negotiate better pricing with payers and insurance companies.
The top carrier/insurance analysis report tracks collection per total Relative Value Unit (RVU). Physicians submit claims using CPT codes for the procedures they complete, and every CPT code has a total RVU assigned to it. This RVU helps determine how much your practice is paid for each of its services. By looking at the collection per total RVU rate for given procedures, you can gauge how good your practice’s rates are, how you’re getting paid for certain procedures, and how your revenue cycle is going.
Ideally, you want your top carriers to have a collection per total RVU of about $40 to $50. You also want to see all of your top commercial carriers with very similar collections per total RVU rates. If the Collection Per Total RVU rates for your top carriers is lower than $36.04, you may not be collecting the right amount from your patients. It’s also a red flag if there is a wide variation in the collection per total RVU rates for your top carriers. If you find that one carrier is paying you a significantly lower amount for the same procedures, you may want to consider dropping the carrier or renegotiating your contract.
‘E2E Medical Billing Services’ share essential medical billing reports as part of our billing services. We don’t charge anything extra for it. We share customized billing reports on a weekly and monthly basis with our clients. Our billing experts conduct meetings with clients to share our insights and discuss the next line of action. To know more about our medical billing services contact us at 888-552-1290/ [email protected]