Report Descriptions

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Reporting Cubes

Reporting Cubes are dynamic, multi-dimensional views of data that allow clients to run their own reports to answer questions regarding revenues and ageing. Some of the variables include posting date, place of service, provider, diagnosis, procedure, insurance and referring physician. These powerful reports measure each event in the claims lifecycle, allowing your practice to understand exactly what is happening and how to improve efficiencies in each department. These reports are available 24/7 via the Web.

Description of the Basic Cubes

Revenue Cube - Daily
The revenue cube provides an environment to analyze summary data related to charges, payments, adjustments, RVUs, and charge count. Various dimensions that are able to be manipulated within the revenue cube include posting date, place of service, provider, diagnosis, procedure, insurance, and referring physician. Data is updated daily and can be exported to Microsoft Excel or into a .pdf format.

Ageing Cube - Daily The ageing cube allows users to dynamically analyze summarized receivables based on the standard ageing intervals (30d, 60d, 90d, etc.) as well as balances that have resulted in a credit situation. Various dimensions that are able to be manipulated within the ageing cube include ageing buckets, provider, place of service, current insurance, and balance type. All balances sent to Collections are excluded from the Ageing cube. Data is updated daily and can be exported to MS Excel or into a .pdf format.

Ageing Cube - Monthly The monthly ageing cube is a snapshot of the daily ageing cube taken at month end. The cube is updated monthly. This cube can provide a baseline when analyzing movement of Accounts Receivable balances throughout the month.

Strategic Reports

There are six standard strategic reports updated monthly and available to the customer via the Web. The reports with definition are listed below.

• Monthly Ageing Analysis Reports

Ageing by Payor Class
Monthly summary of accounts receivable grouped according to standard ageing intervals (30d, 60d, 90d, etc.) The report is broken down by major insurance groups (Medicare, Medicaid, HMO, BCBS, Other, Self).

Ageing by Revenue Center
Monthly summary of accounts receivable grouped according to standard ageing intervals (30d, 60d, 90d, etc.) The report is broken down by the client’s revenue centers (CPT code groupings.) The .pdf format allows for multiple roll-up views of the entity.

Ageing by Top 10 Payors
Monthly summary of accounts receivable grouped according to standard ageing intervals (30d, 60d, 90d, etc.) The report is broken down by the client’s top 10 payers based on accounts receivable. The .pdf format allows for multiple roll-up views of the entity.

• Monthly Revenue Analysis Reports

Monthly Productivity
Monthly and year-to-date summary of key productivity measures including charges, payments, adjustments, RVUs, and charge counts. The report is broken down by the client’s revenue centers (CPT code groupings.) The .pdf format allows for multiple roll-up views of the entity.

Monthly Revenue by Location
Monthly and year-to-date summary of key productivity measures including charges, payments, adjustments, RVUs, and charge counts. The report is broken down by the client’s various places of service. The .pdf format allows for multiple roll-up views of the entity.

Collection Ratio
Monthly report that matches payments and adjustments to the month in which the charge initially occurred. Analysis allows client to review balance due and/or credit balances outstanding on prior month charges. The .pdf format allows for multiple roll-up views of the entity.

Operational Reports

Denial – First Pass Denial serves as the foundation for working accounts receivable. Denial creates a work list of line items that have been denied by the payor along with the reasons for denial, which is taken from the explanation of benefits (EOB). The report helps the client to classify denials by reason to get a broader understanding of the cause (i.e. – verification of benefits, insurance contractual issues, coding, etc.). The First Pass report captures all denials received from a payor where the denial is the first one posted against the charge. Denial only pulls denials posted during the reporting period and is not a cumulative report.

Denial – All Subsequent
The All Subsequent report captures denials received from a payor where the denial is not the first one posted against the charge. The All Subsequent report only pulls denials posted during the reporting period and is not a cumulative report.

No - Response
Designed to monitor all charges that have been entered into the system and have not received any correspondence from the payor. With the onset of HIPAA regulations, the number of claims being lost or delayed within a payor’s system has increased across the industry. By monitoring this report on a regular basis, Response is able to quickly identify those charges that need to be followed up on in order to receive payments in a prompt and timely manner.

Allowable
Allows the client to retrospectively examine contracts with individual payors. The report captures, from the explanation of benefits (EOB), what the payor says is the contracted allowed amount based on the client’s current contract and the way the charge was coded. Sorting by dates of service, procedure codes, provider, and other descriptive information such as units and modifiers add value in determining validity of the reimbursement. RVU’s and the Medicare allowable fields serve as a baseline to compare what percent of current year Medicare the client is being reimbursed.

Adjustment
Examines both contractual adjustments taken by the payor and management adjustments taken by the practice in order to evaluate overall accuracy. Without loading every fee schedule, this report allows one to examine adjustments that are higher than 75% of charge amount which may be caused by posting/payor adjudication errors or procedures that have a high contractual adjustment. Adjustment allows for easy sorting by fields such as provider, account number, or payer in order to find trends in procedure codes, modifiers, or units.

Payment
Captures charges that were closed through either payment or adjustment during the previous reporting period. This report can be a useful tool in determining a true pmt/RVU by payor, BRDHOS and procedure code. With the inclusion of the Medicare benchmark a customer has a baseline which to value contracts and easily identify those with poor reimbursement.

Cash Report
A customer specific report that tracks total dollars received on a daily basis as well as the type of money. The cash report provides monthly projections, average daily collections, prior month and prior year comparisons.