Analysis Reporting

  1. Financial Reports:
  • Revenue reports: detailing the organization’s financial performance, including revenue generated from different sources (e.g., insurance payments, patient payments).
  • Accounts receivable aging reports: illustrating the status of outstanding payments from insurers and patients, categorized by aging buckets.
  • Financial forecasts: projections of future revenue, expenses, and cash flow based on historical data and current trends.
  • Monitor accounts at 30, 60, 90, and 120 days old accounts
  1. Coding and Billing Reports:
  • Coding accuracy reports: assessing the accuracy of medical coding practices, including code utilization, code assignment errors, and compliance with coding guidelines.
  • Billing performance reports: tracking key billing metrics such as clean claim rate, denial rate, and days in accounts receivable to evaluate billing efficiency and effectiveness.
  • Claim submission and adjudication reports: providing insights into the status of submitted claims, including acceptance, rejection, and adjudication outcomes.
  1. Audit Reports:
  • Audit findings reports: summarizing the results of coding and billing audits, highlighting areas of non-compliance, errors, and opportunities for improvement.
  • Compliance reports: documenting the organization’s adherence to regulatory requirements, payer policies, and industry standards based on audit findings and assessments.
  1. Denial Management Reports:
  • Denial analysis reports: analyzing claim denials to identify root causes, denial trends, and patterns, facilitating targeted interventions and process improvements.
  • Denial resolution reports: tracking the status and outcomes of denied claims, including appeal outcomes and recovery amounts.
  • Identified payers with common denials.
  1. Performance Metrics and KPI Reports:
  • Key performance indicator (KPI) reports: monitoring performance metrics related to revenue cycle management, coding accuracy, billing efficiency, and compliance.
  • Benchmarking reports: comparing the organization’s performance against industry benchmarks and best practices to identify areas for improvement and optimization.