Physicians and their practice managers need an efficient and systematic way to monitor financial performance. The standard “bottom-line” measures focus on provider productivity and aged accounts receivable (A/R). Additional operational measures are useful to identify and respond to common problems in the revenue cycle, such as missing charges or claim denials related to insurance eligibility. How can practices best use the reports and functionality available in Allscripts PM?
Practices may track productivity based on charges, payments, or work relative value units (wRVUs), depending on their provider compensation formula. For payments and charges, we recommend the Productivity Analysis report, which is run by monthly reporting period based on updated transactions. For wRVUs, we recommend the Procedure Analysis report – which is also useful to show the detailed visit volume by CPT code. Only the Performance Management report can show productivity by service date; however, the data are computed based on the original charge (not updated transactions) so the numbers change when that report is run at different times, as payments and voids are entered. Also, it should be noted that none of the reports count unassigned payments until they are applied to charges.
The Aged Trial Balance report shows A/R in 30-day aging bracket, and is usually formatted by insurance category (Blue Cross, Medicare, etc.). It can be run three different ways – by service date, billing date, and original billing date reflecting transfers. While the first best reflects overall cash flow, the third best reflects billing office performance. The limitation of the second is that, when a claim is rebilled (for example, to appeal a denial or correct a claim format error), the billing date changes to the new one and the A/R bracket is adjusted accordingly. We recommend creating a spreadsheet to compile the data and compute percentages, to make it possible to track performance trends. Monthly tracking is sufficient if A/R is mostly current (< 30 days), but weekly or biweekly is better if there is significant old A/R. The A/R Analysis report computes average A/R days, a good indicator to compare with other practices.
In addition to those statistical reports, a few key operational reports are well-worth monitoring. The Appointment Analysis report can be used to compute utilization of the scheduling template by provider. The Encounter Tracking report identifies missing charges for scheduled visits; if this is a significant problem, the data can be exported to a spreadsheet-file for analysis and distribution to providers. The Reimbursement Comment Analysis report summarizes claim denial reasons; categories can be set-up and linked to simplify reporting (for example, coding or insurance eligibility) and provide feedback and follow-up training for providers and practice staff.
The Office Manager module is also a valuable tool for monitoring operational performance in real-time. Automated work queues and work groups can be set-up for staff to facilitate their assigned follow-up work (for example, referral authorization or denied claims). Managers then have a simple transparent way to oversee workloads and progress in working-down backlogs. In our experience, the Workflow Organization option to prioritize queues is advantageous, especially for clients with significantly old A/R.