By Sandie Hunnicutt, MedVision, Inc.
Medical Billing and Revenue Cycle Management Services
714.258.0011 x 226

The ability to receive good monthly reports is one of the topics of discussion I hear frequently when I visit physicians who are looking to outsource their billing or change billing companies. It seems that either they have had difficulty obtaining good information or the reports are too cumbersome to decipher in a usable and friendly format.

There is no time like the present to assure that a medical practice receives the data they need to evaluate the results of their practice. While most practice management billing systems today can provide a myriad of reports, there are some that are essential and should be run and analyzed each month. These reports contain the “key indicators” of information which assist in diagnosing the financial health of the practice.

Monthly Financial Summary Report

This report should contain summary information on each individual physician’s results through the month and should conclude with a section which summarizes the practice as a whole. Total Charges, Receipts, Adjustments and Current Accounts Receivable should be the hallmarks of the report. The report should be broken out in a period-to-date summary of the current month as well as an aggregation of year-to-date results. Ideally, it should also contain a summary of each key category of receipts broken out according to the specifications of the practice. A few examples of categories could be Medicare, Patient or Capitated. Lastly, the report should summarize the various adjustment categories for the month by payor group, for example, Blue Cross, Medicare, Medi-Cal, all payer categories the practice defines as needing adjustment information from. With this report, calculations can be made as to the average aging of days outstanding as well as the collections ratios. This information will allow a practice to track how effective they are at timely collecting as well as what percentage of total dollars billed they are collecting.

Procedure Productivity Report

This report should be set up to group information in logical sequences so that the practice can evaluate work productivity among each physician in the practice. Examples of categories could be new patient visits, established patient visits, initial hospital visits, follow up visits, surgeries, procedure categories and drugs, etc. Each group should have a subtotal of charges based on units of procedures as well as total charges for each category. This report should show period-to-date results and well as year-to-date results. Information grouped this way will allow a practice to monitor and compare monthly the volume of business the practice is receiving and producing and will allow a comparison by physician..

Accounts Receivable Aging Reports

• Summary Aging By Payer

- This report will show the aging categories of each of the payors and will allow a practice to see problem trends/delays among payers.

• Detailed Insurance Aging

- This report will show the status of each patient’s outstanding insurance balance and can be used to zero in on particular patient payment concerns.

• Patient Summary Aging

- This report will show the aging of each patient’s balance and will highlight the problem accounts before they can grow too large.

Top 10-20 Accounts

This report should identify those patients that have the highest cumulative balances with both what insurance owes and what the patient owes. This information should be looked at carefully each month as it will trend the largest problem accounts and allow the practice to address issues before the receivables grow too large.

Referring Physicians Report

This report is valuable when run on a quarterly basis. It will allow a practice to see which colleagues are referring to them and be able to see trends in increasing or decreasing referrals.

Lastly, most physicians find mulling through reports each month too tedious and time consuming. It is important to have this level of detail to refer to for analysis purposes. Ideally though, the person producing these reports should take the “key indicators” of information and produce a monthly spreadsheet that is easy to peruse and zero in on the main results for the month being reviewed. A sample summary spreadsheet should contain, at a minimum, the following information for each month:

Total Charges

Total Receipts

Total Adjustments

Total Accounts Receivable

Insurance Aging broken down in categories by what percentage is: current, 1-30 days, 31-60 days, 61-90 days and anything over 120 days

Patient Aging broken down in the same arrangement as above

Average Aging Days for the Month

Any other specific information a practice wants to track specific to their specialty

There are many other good reports that provide valuable information, but the reports referenced above are critical indicators of the financial results of the practice. In addition to the Practice Administrator’s watchful eye, physicians should also make a habit of looking at this information diligently each month.