Lab practitioners need an efficient and reliable framework to get digital financial reports. It is essential to have medical billing reports for analyzing the efficiency and effectiveness of a lab billing system. These reports provide a clear view of what’s going on in your healthcare organization in full detail.
You get accurate information about the economic health of your practice that will help you keep your facility financially sound_ and save you from lost revenue, increase reimbursement average, free up staff to better serve consumers, reduce insurance denials rate, or improve AR recovery services. Moreover, you get a complete understanding of problematic areas in your revenue cycle process and how to fix them.
The data analytical reports can save practices from a financial loss just like Dr. David Fairbrook_ a Geriatrician in Lacey, WA who lost more than $36,000 in one year. The reason behind this was inefficient billing practices. Practitioners have had to bear the burden of opposite outcomes. Therefore, now it is highly important to understand the medical billing reports to stop losing large sums of money. This can help you to improve your revenue cycle significantly. Notwithstanding, the queries on the report must be able to answer the following;
- Profiles of coding.
- Compliance with the payer’s obligations.
- Referring to medical profitability.
- Providers’ productivity.
- Front-desk employee efficiency.
There are various data analytics that your medical billing report should provide. How can that happen? Keep reading to get more comprehensive knowledge.
Key Performance Indicators Report
The KPI report is a valuable tool for determining the potential areas where performance is critical in your revenue cycle management process. This report helps you measure progress against those objectives and set strategies for those areas that need modifications.
Moreover, this will help you save precious time for your administrative staff. When medical billing frameworks have the capability to run the KPI reports that are designed according to the healthcare industry standards.
Lab professionals get an uninterrupted view of their billing performance when the key performance indicators report run on average once a week. At this point, they become able to figure out any breakdowns and problems in the practice functionality.
Besides, like other organizations, you must know the beneficial procedures in your practice. So, you would be aware of which CPT codes and services are most profitable for your business. During your critical performance indicator report you become able to track the following;
- Total alterations in the RCM process.
- Frequency of conducting a procedure.
- Outstanding accounts receivable.
- Sum or collection charges.
Make sure the report is clear so you can compare results easily on a pre-date basis when records are presented in document forms. A minor or sudden leap in days/weeks must be monitored closely so you can track the dates accurately.
A/R Aging Reports
The A/R report gives you a complete picture of the overall financial health of your lab practice. It is such a great model that helps an experienced biller to tell whether your billing department is doing great or not. However, the amount of time it takes to make an A/R aging report is impractical when you technically generate it by hand.
Luckily, many medical billing systems are equipped to create such sort of and related reports that can give a more in-depth view of your A/R status. These reports include insurance collection reports and insurance payment trend reports.
The report also covers the accounts which are to be reimbursed by the insurance agencies. This shows how long a medical claim will need to get paid_ and how much time A/R has to remain unpayable from the insurer’s end before it gets reimbursed.
It takes an average of about a month for a claim to get reimbursed. Firstly, the follow-up reports give you a high-level view to see what problems are the reasons that are leading to payment delays. Secondly, A/R aging reports allow you to determine the potential issues by taking a close-up view.
For instance, one lab facility says they try their best to submit the claim within five days of filing. In less than forty-five days medical claims would be reimbursed which may not be possible in five days. Professionals need to act urgently when it reaches 90 days. It is a red sign. Any demand must be monitored which is compensated for 45 days.
On the other side of the coin, if you see more than one claim taking a lot of time to process, don’t panic. Many factors like paper/electronic claim submission and your practice’s patient population, etc, can affect this report. Basically, the following are the claims that take longer to process, these are;
- Car crash claims.
- Compensation for workers.
- Claims from outside the state insurance carrier.
Hence, it must be taken into consideration if you have provided any health services in this category. Furthermore, an electronic claim is processed in as little as 2 weeks while a paper claim takes approximately a month to process and has a longer processing time.
Insurance Analysis Report
This is the most useful report for helping lab facilities save money and time. This gives you an idea of a snapshot of how the overall business is doing and also helps track revenue cycle metrics. It allows the organization to drill down into the collections, payments, and charges for a particular CPT code. Practitioners get access to important data that can help them to properly negotiate better pricing with insurance agencies and payers. Most significantly, this report tracks Collection Per RVU (Total Relative Value Unit). However, what is RVU? Some elements that represent it are;
- 4% expenses of malpractice.
- 52% work expenses for practitioners.
- 44% expenses of the facility (overhead, staff, operational).
Every CPT code has a total RVU given to it when the provider submits medical claims using CPT codes for the processes they complete. That Total Relative Value Unit tells you how much you will be paid for the rendered services. Practitioners can gauge how their RCM is working? How are they getting paid for certain procedures? And how good their business rates are? With the help of Collection Per Total RVU rate for assigned procedures.
At this point, lab practices become able to better negotiate with other insurance providers for more favorable rates after knowing the list of the procedures per total RVU offers. In addition to this, you can consult with lab billing & coding experts to streamline your AR recovery services_ and evaluate your current medical billing reports to gain better financial outcomes.
