Date post: | 17-Jan-2017 |
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Automated Revenue Reports
Decreasing Denied Claims
Reliable And Efficient Business Intelligence System
Medical Billing Reports
Every Practice Needs!
Payment Trend and Collection Reports
The Accounts Receivable Aging Report 1 Payment Trend and Collection Reports
The Key Performance Indicators Report
The Top Carrier/Insurance Analysis Report
Patient Payments
3
4
5
2
www.thebillingbridge.com
Tracking Clearing House Rejections 6
Tracking Payer Reimbursement Metrics 7
Tracking Denials 8
CPTs contributing to your practice’s revenue9
No of claims submitted10
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The Accounts Receivable Aging Report #1
Analytics helped a hospital in the Midwest with less than 200 beds to find out that it's
claims held were more than 27 percent higher than it's peers and the result was $5.24
million in the claims held.
The director of patient financial services at the hospital pulled out a review of the
claims held and ordered A/R to help release the claim a top priority. In not more than
six weeks the hospital was able to reduce held claims A/R days from 3.5 to 1.0 days
and how much they were able to cut the stuck revenue? To $1.41 million and yes it's a
great achievement.
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To get more deep insights, we can divide the A/R reports based on insurance and CPT codes
You can pull up a report for A/R based on insurance
www.thebillingbridge.com
A/R report based on CPT codes.
What information does this report provide?
The report shows which claims have not been paid.
It takes, on average, one month for claims to be paid.
www.thebillingbridge.com
Payment Trend and Collection Reports #2
Claims that are over a specified number of days and have not been paid can be seen in the
Insurance Collection Report. One can use the Insurance Payment Trend and Collection
reports to further analyze the problem, in more detail, when one sees an issue in the accounts
receivable aging report.
You can pull up a report your claims and payment trends summary based on the DOS (date
of service). This would help you know the claims value and how much the insurance paid. A
sample report should like a one below:
www.thebillingbridge.com
By looking at the report one can judge how much is to be collected from patients to
pay their claims.
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The Key Performance Indicators Report #3This is one of the most valuable reports. Using it one can pinpoint the encounters and CPT
codes providing most profit. In the past this report had to be done by hand. It took up to a
month to complete. Today, efficient software generates the report in seconds. Practices
get data in real time.
The report keeps track of total encounters, total number of procedures, total charges,
total collections, outstanding A/R, and total adjustments. It provides indicators which
billers use to judge trends which are negative and positive, thus enabling practices to
change what does not seem to be working and continue to do what is working.
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If the report shows that charges increased one month, but the next month collections did
not increase, then there is a problem. Similarly, the report will show if, all of a sudden, there
is a drop in collections which have been consistent in the past.
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The Top Carrier/Insurance Analysis Report #4This report helps save both money and time. It gives practices an overview of how they
are doing. The report does this by tracking revenue cycle metrics. The report shows the
top 10 payers and insurance companies which contribute to the major portion of the
business of a practice.
The Top Carrier/Insurance Analysis Report allows practices to track Collection per Total
Relative Value Unit (RVU). This gives practices information regarding how good their
rates are. It also provides information about how a practice is getting paid for certain
procedures and how its revenue cycle is proceeding.
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Using this report a practice can highlight the carrier which is paying less than other
commercial carriers allowing it to drop that carrier and save up to $50,000 a year.
Instead of dropping the carrier, the practice could renegotiate a better deal. While the
option a practice chooses varies, the important thing is that the report allows practices
to make informed decisions.
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Patient Payments #5It's challenging for front office to convince a patient who doesn't know his benefits and to
get the patients to pay, once they step out of the office is the most challenging task. Due
to Affordable care Act and employers plan enrollment, out-f-pocket expenses is on a high
and keeping a track of patient’s collection has become the need of the hour.
As a result it is the need for an organization to keep a track of the payments collected
from patients. A business intelligence tool that integrates with your EMR could be of a
great help. You can get a report like a one below.
www.thebillingbridge.com
These reports can be pulled up with the help of a reporting tool or by using an App
which integrates with your EMR and delivers the above reports straight to your phone.
www.thebillingbridge.com
Tracking Clearing House Rejections #6Clearing houses have reported as seeing claims for ICD-10 with wrong qualifiers. The
reason could be incorrect settings in the vendors application. Some organizations
reported unpredicted issues with small payers. It points out that payers who made
changes to their applications after ICD-10 caused rejections which were not related to
ICD-10. Recommended ICD-10 Provider Benchmark Metrics
ICD-10 Benchmark metrics every provider must followWhat are your Front-end rejection error rates
What are the average days from claim submission to paymentWhat is the denial rate variance metrics (payor/provider benchmark)
Dollars submit on claims, dollars denied
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It is important to keep up with the above benchmarks and to achieve it, tracking the
clearing house rejections and automating the process with a business intelligence App is
one solution every health IT expert recommends. An example of a report, every medical
practice must have.
www.thebillingbridge.com
Tracking Payer Reimbursement Metrics #7Tracking the reimbursement metrics can help you better the above metrics. Yes, using a
reporting tool is of a great help but if you are not someone who can drag a customized
reports, it can be challenging and frustrating. So automating the reporting tasks and using
a Revenue Analytics App will help you smoothen the reporting and the tracking process.
Keep a track of your average claims reimbursement TAT to see if it is consistent.
Example your TAT for three months shows 22 days, for the last six months shows 29 day
s and for the last twelve years shows 38 days. This could help you review your
claims held and hence reduce the days in A/R. A report shows how practices are
pulling up reports to find out their TAT.
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The above report shows the average claims reimbursement TAT for last twelve months.
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Tracking Denials #8Building a concrete denial handling strategy requires high experience and skill. It demands
a pattern to be recognized specific to an insurer. This is possible with analytics. It can not
only help organizations to develop a pattern but recognize how much money they can
recover with the help of a revenue analytics system in place.
Having said that, you can have reports for claims denied based on two different categories
to get a better approach towards creating a strategy.
What information does this report provide?
Top 10 CPTs for which claims were denied.
Top 10 payers who denied the claim.
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Top 10 Payers which denied the claims
Automating this process would save your time and prevent clerical errors. Many
organizations are now using business intelligence to automate the complicated and
tedious process of reporting and analytics.
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CPTs contributing to your practice’s revenue # 9
There can be nothing bigger than office visits which contributes to practice’s revenue.
Practices need to recognize what how they can make more out of office visits.
Determining the CPT codes and documentation needs to help you boost revenue is what
the billing office needs to find out.
Apart from urgent care, its tough for other specialties to make most out of office visits.
This is where better understanding of documentation and coding plays an important role.
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Since the automation industry has turned the face of practice’s workflow, experts
strongly recommend business intelligence to help practices leverage the reports. A
report for the Top CPTs for reimbursements.
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No of claims submitted. #10
you want to know how many claims are waiting to be released and who’s responsible. A
picture which shows complete view of how many dollars are pending for a month will
help to take quick action and decrease the risk of high A/R aging.
To understand where did the error happen and the amount of claim, it takes a
long time to find out if you don’t have an aggressive team to work on it. So in the
first place you need to know how many claims your practice submits per
day/month. This is the first data you need to collect. Having an application that
integrates with your EMR could help you show the accurate number of claims
submitted. And then starts your mathematics of getting paid.
www.thebillingbridge.com
The above report gives you the number of claims submitted for the weeks, amount
billed for a particular week and the Total billed amount. Similarly you can get a report
for the number of claims submitted for a particular month or a year.
www.thebillingbridge.com
TheBillingBridge provides the medical billing reports needed to save money and time. It
provides collection reports, impact analysis, revenue analytics, and key indicators so that
a practice can free resources and clinical staff to better serve patients.
It empowers practices to reduce insurance company denials, increase
reimbursement average, and remain financially sound. www.thebillingbridge.com