11 reports to ask from your biller
Presenting a collection of reports that form benchmarks for practice performance. These are a standard set of outlines that you can ask from your biller and are crucial for measuring and tracking practice growth.
1. Established vs. New patient visits: A comparison report of new and established patients at the practice. Compare it with other physicians in the group or monthly/quarterly numbers for solo doctors. If the numbers are very different then identify the reason and fix it. It can be evidence of mismanaged schedules or poor patient satisfaction.
2. Missed appointments: List of all patients who missed appointment without prior notification. Missed appointments without prior notice is costly for practices. Ask for a report weekly to identify the number of missed visits. Efforts should be concentrated to reduce the number overtime.
3. Open claims: This is a report for claims that have not been submitted to carriers due to some missing information. Patient’s insurance information, eligibility, authorizations are some of examples of missing information. Identify the open claims. Reconciliation of open claims in a timely manner would ensure everything is billed without anything left on the table.
4. Account receivables: A report of money that is owed to the practice from insurance and patients. Industry standard points towards keeping 90+ insurance receivables under 20%. Ensure most claims are in the recent 30 to 60 days of claim cycle. Setting protocols upfront patient collections and appropriate follow-ups help contain patient receivables.
5. Quality control reports: A report of submission accuracy, number of errors (billing and coding). Scrutinize claims before submitting them to carriers. Study the report to track improvement in accuracy.
6. Charges vs. payments: The analysis of the total charges billed and the corresponding reimbursements received over a definitive period. This report can be used for weekly, monthly, quarterly and yearly analysis. It helps in determining practice progress over time.
7. Procedure volume analysis: The count of all the procedures performed at the practice – the most and the least procedures done.
8. Procedure billing analysis: This report can help you determine the total charge amount submitted to carriers for each procedure. By analyzing the corresponding reimbursements, which procedures got the highest reimbursements can be determined.
9. Facility analysis: The count of total patient volume across different facilities/locations and the charges billed from each facility. By asking for this report, which facility has the most patient volume can be determined.
10. Payor-Mix charges: The break up of all the top carriers and their charge amount.
11. Payor-Mix payments: The break up of all the top paying insurances.