Legion Healthcare Solutions

5 Essential Medical Billing Reports for Your Practice

5 Essential Medical Billing Reports for Your Practice

Medical billing reports help in keeping track of the financial health of your practice. Medical billing reports would show 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, among other things. Depending upon the process flow of your medical billing functions various customized billing reports are useful. In this article, we shared 5 essential medical billing reports which would track the performance of key processes and would apply to all healthcare practices of various medical specialties.

AR Aging Report

The Accounts Receivable (AR) aging report is the most important report for your practice, without any doubt. AR aging report will pinpoint which claims the insurance companies have not paid. The reason this is the most important medical billing report is, it shows you how long they have been unpaid. On average it takes one month for a claim to be paid and the AR 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. However, it is also important not to panic if you see many unpaid claims when you check your AR 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. Workers’ compensation and car accident claim generally take longer.

KPI Report

As the name suggests, the Key Performance Indicators (KPI) report shares crucial information about key processes that affect the financial health of your practice. For example, they will highlight which procedure is more profitable. This report will 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. Most practices run this report every week. You can compare the results to the previous week to 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.

Insurance Analysis Report

The insurance analysis report provides crucial information about top insurance carriers and their payment pattern. This report 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 (RVUs), which gives you 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 insurance carriers. 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.

Claim Denial Report

No matter how hard you work to avoid denials, still, your claims will get denied. Constantly changing billing & coding guidelines, payer reimbursement policies directly affect claim status. Claim denial report will help to track denials as per denial reason, insurance carrier, and soft and hard denials. By understanding stats from the claim denial report, you can find a pattern in denials. You can create a denial management system based upon data from the claim denial reports. As you are spotting denial patterns and making insurance carrier-specific strategies, you will be to keep denials less than 5 percent of total submitted claims.

Patient Payments Report

With more and more patients opting for High Deductibles Health Plans (HDHP), patient responsibility is increasing to a great extent. Getting patients to pay their medical bills can be difficult, especially if the bill is high. Tracking patient payments is a necessary part to keep your practice 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. On-time and maximum collection of patient payments will ensure the smooth functioning of your practice.

Legion Health Care Solutions is a leading medical billing company that can assist you in revenue cycle functions for your practice. Including above mentioned 5 essential medical billing reports, we share customized reports as per requirements of your practice. Please call us to know more about our billing and coding services at 727-475-1834 or email info@legionhealthcaresolutions.com