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6 Most Important Medical Billing Reports

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Ensuring that your practice is functioning efficiently involves investigating many things. One of the parts of your practice that needs to be working smoothly is your billing process. Medical billing reports are an important way to learn about this. They can give you vital information about claims, payments, and a variety of other aspects of your practice. Though there is a wide array of reports you should be checking for your practice, some should take priority over others. Following are 6 of the most important medical billing reports that your practice should check frequently.

The Accounts Receivable Aging Report

The Accounts Receivable Aging Report is arguably the most important report for your practice. It reveals which claims the insurance companies have not paid.

One of the best parts of an Accounts Receivable Aging Report is that it not only shows you which claims have yet to be paid, it shows you how long they have been unpaid. On average it takes one month for a claim to be paid and the Accounts Receivable Aging Report can tell you which claims have been open for longer than a month. If you see a claim that has taken longer than 45 days to pay, you should take note. You may need to take urgent action if a claim is still unpaid after 90 days. You should check your Accounts Receivable Aging Report frequently.

However, it is also important not to panic if you see many unpaid claims when you check your Accounts Receivable Aging Report. Many things can affect the numbers on this report such as the
number of patients you have, and whether you use paper or electronic claims. Additionally, aspects of the claim itself may affect the speed. Workers’ compensation and car accident claims generally take longer. Out-of-state claims will also most likely take longer to be paid.

Though it is possible to generate this report manually, it takes a long time. Additionally, practices with more than 15 patients will most likely lose money if they neglect to use software to generate an Accounts Receivable Aging Report.

Payment Trend and Collection Reports

If you see red flags in your Accounts Receivable Aging Report, Payment Trend and Collection Reports can help you get more information about what may be going on. They show information about how much you have billed and collected. The Insurance Payment Trend Report shows this number in comparison to what the insurance allows. This report tells you how much you should collect from your patients to pay their claims.

The Insurance Collection Report, similar to the Accounts Receivable Aging Report, shows how long a claim has been unpaid. By looking at both of these reports together, you can learn more about issues that you may spot in the Accounts Receivable Aging Report.

The Key Performance Indicators Report

From a financial standpoint, Key Performance Indicators Reports provide some of the most important information for your practice. They show you which procedures are the most profitable. They track the number of times you have performed each procedure, the sum of your charges, the sum of your collections, outstanding A/R, and total adjustments. Along with presenting this information separately, they combine it to provide you with a clear idea of the profitability of your procedures, appointments, and treatments.

In previous years, medical practices needed to generate Key Performance Indicator Reports manually, and they could take up to one month to create. Now, there is software available to compile the information into a simple, straightforward report.

You should run this report every week. Compare the results to the previous week so that you can have a more exact idea about the problem as soon as it appears. If you see sudden changes in the collections, you may have a problem, and should look deeper into that specific issue to determine what is wrong and how you can fix it. Analyzing other reports can be an effective way to identify the problem.

The Insurance Analysis Report

This report provides important information about the insurers, which can help you make important choices about revenue. It tracks revenue cycle metrics and shows the top ten payers and insurance companies that contribute the most to your business. It also gives tracks your Collection per Total Relative Value Unit, which gives you with information about your rates and how you are getting paid for certain procedures. The Insurance Analysis report gives you the information you need to negotiate better pricing with payers and insurance companies.

Ideally, you want to see that the Collection per Total Relative Value Unit is higher than the current Medicare Conversion Factor. If it is lower, you might not be collecting the right amount from your patients. If you see that some of the carriers are paying significantly less, it may be an indicator that you are not getting a fair deal. You may want to think about dropping that carrier for another one that pays better. Though dropping a bad carrier can save your practice thousands of dollars a year, it is important to think carefully before doing it, because it is a significant decision.

Experts recommend that you run the Insurance Analysis report at least two times a week. The sooner you can catch a discrepancy among your insurers, the sooner you can make a change that could save you a significant amount of money.

Patient Payments

Another vital set of reports that your practice needs to consistently analyze are patient payments. Getting patients to pay their medical bills can be difficult, especially if the bill is high. Tracking patient payments is a necessary part of ensuring that your practice is profitable. Medical bills are the leading cause of bankruptcy in the United States and lead many people to fall into debt, so the chances of someone delaying or trying to skip a payment are high.

Clearinghouse Rejections

It can also be helpful to track your clearinghouse rejections. Rejected claims waste precious time and damage your profitability. If you track clearinghouse rejections, you can identify common issues and work to reduce those problems on future claims.

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Apex EDI, Inc.
556 E Technology Ave
Orem, Utah 84097
Support: (800) 840-9152
Sales: (801) 383-0388
Fax #: (801) 642-0333
 
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