
4 Charlesview Road, Suite 4, Hopedale, MA 01747
(508) 422-0231 Consulting Services
(508) 422-0233 Account Matters
E-Mail: info@dmbmcsi.com
As an administrator, wouldn’t it be great to get daily, weekly, monthly and yes, yearly statistics and information that would sum up how your practice is doing at any particular time? Yes, it would, but now the question is what stats or information are best to help you identify how well you are doing or when to get concerned?
All statistics and informational data have to come from a valid source. Manual systems are not a valid source – too much room for error and/or manipulation. Your billing system is a valuable tool and a great source for data. It is also a major tool in holding staff as well as yourself accountable.
With the proper systems of reconciliation set up and based on the assumption that you are consistently up-to-date on your billing and posting payments into the system, stats should be readily available and ready for your review at anytime.
Daily reports that are helpful in the day to day operations include:
1. Total of patient’s scheduled, seen, cancels, no shows, new patients
a. From this information you can better manage the % of arrival and work to consistently keep your cancellation and no show rate low.
2. Daily charges
a. Charges for patients seen, cancels, no shows (even if you don’t charge a fee, you should have a zero charge applied to cancel and no show patients). This insures accountability – all patient’s scheduled have been accounted for.
3. Billing stats
a. Ensure that the total patients charged were actually billed
b. Ensure that all charges passed edits – rejections were addressed and rebilled – this helps to identify repeated rejections that can be fixed to eliminate the problem.
4. Payments – including all patient payments made at time of service, insurance payments
received in mail and electronic funds transfers (EFT’s)
a. Total of payments entered must balance with the bank deposit including EFT’s – this is particularly important to insure integrity of the system and staff
b. Stats breaking out payments made by patients assist in insuring that maximum co-pays are being collected at time of service.
Weekly data that should be reviewed in an effort to keep the administrative bar high include:
1. A consistently updated Accounts Receivable (A/R) report – keeping an eye on accounts that are aging from current to 30 – 60 days old and addressing the reasons at that time help keep the A/R under control and insure collections on most accounts.
2. Inactivity data – a list of patients who have not come in for treatment for a week or more is
critical to insuring that no patient’s fall through the cracks.
3. Referral/authorization data – a list of patients whose referral needs updating and/or authorization is expiring is an absolute to insure that all patients seen have the appropriate referral and/or authorization. Addressing this issue on a daily/weekly basis once again insures payment on claims
4. All daily stats and data put together on a weekly report helps identify problems before they get out of control.
Monthly stats are most important as they can be compared to the last month(s) and years. Doing a comparison analysis from one month to the next and from year to year will indicate patterns of growth, downtimes, assessing staff productivity and areas of concern.
Monthly stats necessary for comparison and knowing where the practice stands include:
Total charges
Total payments – patient and insurance
Total payments applied by age of the accounts
Total adjustments
Current A/R
Expected payments based on charges
Number of work days in the month
Average daily visits
Total monthly visits
Total new patients – by referring physician and by insurance
Total cancellations and no shows
Total discharges
Total statements and claims sent
Stats can be customized to give you the outcomes you are looking for. Statistics are the results of accurate data being entered into your billing, scheduling and/or documentation systems.
Diane McCutcheon, President
DM Business Management Consulting Services, Inc.
Account Matters – Billing & Collection Services
4 Charlesview Road , Suite 4
Hopedale, MA 01747
P: 508-422-0231 F: 508-422-0234