1) Aged Accounts Receivables Report
The most vital report to determine the health of your billing is the Accounts Receivable Aging report. An aging report that breaks down unpaid claims at 30, 60, 90 and 120 days (and beyond) should be viewed monthly. Ideally, the aging report should show that the majority of your claims are being paid by the 30 day mark and not being pushed in to the older aging buckets. The graph below illustrates an example of a healthy Accounts Receivable curve.
If you find that your accounts receivable aging buckets past 30 days are increasing, it is probable there are billing processes that need to be addressed immediately.
2) Contractual Vs. Paid Discrepancy Report
Are you being short-changed by insurance carriers? Are you monitoring reimbursements to verify that insurance carriers are paying their full share of the contracted responsibility? Many times insurance carriers underpay claims and if your office staff or billing agency is not reviewing these discrepancies, there is a chance you are losing out on a significant amount of money. Incoming payments should be audited monthly against the carrier fee schedules for each insurance company you contract with.
3) Adjustments/Write offs Report
Occasionally, even respectable looking aging reports do not tell the whole story. In order to determine if you are collecting maximum reimbursement, your clinic should be monitoring write-offs each month for any irregularities. If you notice a drop in aged AR balances, but not a corresponding revenue increase, it could mean there are improper adjustments taking place that enhance the Accounts Receivable report, but not the bottom line. Adjustments labeled “timely filing”, “not collectable” or “other” are potential indicators that you are missing out on possible payments. If your staff or billing agency is not already providing this report have them include it in the monthly or quarterly totals.
4) Missing Encounters Report
One of the most overlooked reports, is the Missing Encounters report. Tracking patient encounters to verify all charges are being billed is essential if you want to maximize your reimbursement. If your staff or billing agency is not examining your schedule for potential missed visits, there is a chance that some are falling through the cracks. Part of the problem is that missed visits do not show up on aging reports. If they are not entered into the system, there is no way to track the information. If your practice management software has a missed visits feature, make sure it is being utilized to avoid any potential losses. If you are manual entering in charges from super-bills, make sure there is a system in place to compare what is on the schedule versus what is entered into the billing software. We recommend doing this on a daily or weekly basis to limit missed encounters.