3 Data Analytics that Should Always Include in Your Medical Billing Report

Medical billing reports are essential for assessing the effectiveness of your practice. Reports show the performance of your company in full detail. That will help significantly to improve your revenue cycle.

Some of the questions on the report should be able to answer:

  • Referring to medical profitability
  • Front desk employ efficiency
  • Compliance with the contract payer
  • Provider’s productivity
  • Profiles of coding

How can that happen? Learn more about the various data analytics which your medical billing report should provide.

Accounts Receivable Aging Reports

The report includes any accounts for which insurance companies have to pay (A/R). It also shows how much time A/R has been unpayable and how long a claim needs to be paid by the insurance company before it is paid. For example, for CIGNA Health Card holders, Cigna says that they will do their best to process their medical claims within five days of filing. It may not be possible for five days, but in less than 45 day’s medical claims should be paid. Therefore, any demand to be compensated past 45 days should be monitored immediately. It is a red sign when it reaches 90 days that you need to act urgently. You should take the type of claim you request as a friendly note into account as well. Generally, it takes longer to process the following claims:

  • Compensation for workers
  • Car crash claims
  • Claims from outside the State

Thus, any health services provided in this category must be taken into consideration.

The Key Performance Indicators (KPI) report

Your practice should know the most profitable procedures in your organization, just like any company. Thus, you should be able to track the following in your critical performance indicator report:

  • Frequency of conducting a procedure
  • Sum and collection charges
  • Total alterations
  • Outstanding A/R

That should be neatly presented in a document to compare results on a pre-date basis easily. Any sudden surge or leap in weeks or days should carefully be noted so that you can more accurately track these dates.

The insurance analysis report

That lists the top payers and insurance companies, based on the collection per Total Relative Value Unit (RVU), contributing to your practice.

But what is an RVU exactly?

The following components represent this:

  • Work expenses for physicians: 52 percent
  • Expenses for practice (staff, facilities, overhead): 44 percent
  • Expenses for malpractice: 4 percent

The area of the country in which the service has been provided is further influenced by it. That, together with the components above, comprises the total RVU of a specific service.

Why is this important to your practice?

Knowing the list of your procedures per total RVU offers you the leverage to negotiate with different insurance providers for better rates.

How do you know if you are negotiating smartly?

Ideally, the collection should be greater than the existing Medicare Conversion Factor, which is $36.04 per Total Relative Value Unit. If this is lower, then the right amount for your services is not collected. Check who’s paying less among your payers and start talking to them about it. If they disagree with the agreement, it may be better to drop them and add another carrier that pays better. However, be extra careful before you drop one of your carriers because it may impact your practice.

For better results, consult with medical billing and coding experts to evaluate your current medical billing reports. Will you like to know more about medical billing and coding practices? Register for more helpful information on our blog or fill in our online form to arrange an appointment with you. You can also contact us on (281)864-0448 or email us at info@rightmedicalbilling.com.

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