This guide walks you through the key elements and features available on the reporting page, enabling you to tailor your views and maximize its use.
1. Gross Charges vs. Allowed Amounts
The two main metrics summaries at the top of the page are:
Total Gross Charges: The total charge amounts before insurance or other adjustments.
Total Allowed Amounts: The amounts insurance companies have agreed to pay after adjustments and contractual reductions.
2. Revenue Graph
The graph helps you visualize these metrics over time, with the Revenue section showing trends in both gross charges and allowed amounts.
Total Gross Charges (Purple Line): The total charge amounts before insurance or other adjustments.
Total Allowed Amounts (Green Line): The amounts insurance companies have agreed to pay after adjustments and contractual reductions.
You can view the graph by days, weeks, months or quarters, depending on how granular you want the data to appear. Toggle between these options using the drop-down in the top-right corner of the graph.
3. Key Metrics Overview
Beneath the graph, you’ll find summary statistics that give you a high-level snapshot of your data:
Average Daily Gross Charges: A daily average of your total gross charges.
Average Daily Allowed Amounts: The daily average of allowed amounts.
Average Allowable Per Encounter: The average allowed amount per patient encounter.
4. Allowed Amounts Breakdown
This section provides further insight into how much of the billed claims have been allowed by insurance payers, giving you a clear picture of your revenue potential.
The stacked bar graph breaks down the total allowed amounts into three categories:
Payer Revenue (purple): The portion paid by insurance.
Patient Receivables (green): Amounts that are the patient’s responsibility.
Sequestration (orange): Amounts deducted due to government-mandated sequestration.
You can toggle the view between days, weeks, months or quarters by using the filter in the top-right corner of this section. Hover over the stacked bar graph to see a breakdown of these categories.
5. Remit Volume
This graph shows the total number of remit transactions processed over the selected period. The remit volume can provide insight into the frequency of claim payments and reimbursements, helping track overall billing activity. Similar to the revenue graph, you can toggle between days, weeks, months or quarters for a more detailed or broader view of the volume trends.
6. Total RVUs (Relative Value Units)
This section tracks the sum of the total RVUs divided by the number of units billed during the selected period. The graph can be toggled between days, weeks, months or quarters for different time views. You can hover over the graph to get the specific percentage rate for any day or week.
7. Gross Collection Rate
The Gross Collection Rate graph shows the percentage of allowed amounts compared to gross charges for claims that have been adjudicated. It provides insight into how effectively the total charges are being collected.
This rate helps you track the financial performance of claims processing. The graph can be toggled between days, weeks, months or quarters for different time views. You can hover over the graph to get the specific percentage rate for any day or week.
8. Payment Issues
The Payment Issues graph tracks both Paid Line Items (green) and Denied Line Items (red) over the selected time period. This graph provides insight into how many claims are getting paid versus denied, helping to quickly identify potential problem areas in the claims process. The red and green lines provide a visual contrast that makes it easy to monitor spikes or declines in paid or denied line items.
You can toggle the view toggled between days, weeks, months or quarters for a more detailed or broader view of payment issues over time.
