Payments and AR
The majority of revenue cycle analysis is focused on two key areas: the status of the claims and the effectiveness of the collections.
The Aged AR report shown here is usually the first step, providing a high-level assessment of the status of the accounts. Aged AR is a commonly used benchmark, comparing the percentage of charges residing in each aged category against Best Practice percentages. (Click on the report for a larger view.)
From this report, there are numerous ways to drill down, aging claims by payor, payor class, individual physician, revenue center, or last activity on the account, for example. In addition, we measure account performance by number of appeals, days to payment, and an aged accounts receivable assessment that compensates for variances in charge production.
Analyzing payment - or lack of thereof - not only quantifies revenue cycle results, but also provides a wealth of information about where improvements can be made. For a few examples:
- Detailed, itemized denial reports are invaluable tools for identifying and resolving coding or claim issues proactively.
- Net collections percentages detail the amount collected against the amount that was available to collect, removing contractual adjustments and refunds as variables.
- One of our most requested reports is average payment of each CPT code by payor. This report can be used in several ways - to determine if a procedure is profitable, to assess payor performance, and as a contract negotiating tool.