Executive Summary

• The Executive Summary Report shows A/R broken down by month and split into Payments, Adjustments, etc.

• Monthly view can show when/if a problem started in a specific month.

• Shows Patient, Encounter, and Visit volumes.

• This can show if volume dropped significantly compared to previous months.

• APC and APR show the average amount that is being charged per Patient and the average earned revenue per patient.
• Offers multiple KPIs that show financial performance and productivity.
  

Executive Summary KPIs

• Net Collection Rate: Shows how much of the allowed amount was actually collected.

• Best Practices: This number should be as close to 100% as possible. Aim for higher than 95%, which implies that 95% of the dollars that could be collected were collected after adjudication. If the Net Collection Rate is low:

• Review write-off using Payments and Adjustments to assess the reason this money was not collected.

• Transaction Code Reporting Group: WO
• Search for transactions posted where you see an influx of bad debt in the Executive Summary report.
• Include the DOS, Insurance, and Posted Date.

• Are there write-offs posted just a few months past the Post Date?
• Review the Payers associated with the write-offs.

• Determine if Patient A/R or Insurance A/R is more of a challenge to collect.

• Review Copay collection practice, Statement Profile Setups, and consider using POPS to streamline the patient payment process.

• Gross Collection Rate: A low Gross Collection Rate with a high Net Collection Rate could imply a high amount of Denials.

• Review the Denial Analysis Report.

• Look at the overall denial rate (the third percentage in the claim column).

• 5-10% is the average, but aim to be close to 5%.

• Uncheck the "Totals Only" box to find specific examples of why denials are occurring.

• Total Days to Bill: 

• Best Practice: Aim for a 2-5 day average.

• If this number is high, review the Average Days to Add, Complete, and Bill. These three add up to the Total Days to Bill, and will give more insight into why claims aren't making it out the door quickly.

• If there is a high Average Days to Add, and you are utilizing the scheduling module, run the Missing Encounters Report.

• Providers may not be signing off on visits promptly.

• If there is a high Average Days to Complete, review Charge Management Rules and the Incomplete Charge Review Screen to determine what can be included during Charge Entry to streamline the process.

• Days in AR:

• Best Practice: Aim for 30 days.

• If the Days in A/R is high, look at the aging buckets by Payer using A/R Management.

• If Patient A/R is high:

• Review Statement Profile Setup.
• Use POPS to streamline the patient payment process.
• Utilize Interactive Aging to drill down into the older buckets and find the unbilled Patient A/R.

• If Insurance A/R is high:

• Review the Rejection Percentage on the Executive Summary Report.

• If the Rejection Percentage is high, use the Encounters by Status List to find the specific type of rejections ([CE] or [PE}) to learn why they are rejecting.

• Ensure the box "Include Historic Statuses" is checked.

• Review the Denial Rate on the Denial Analysis Report.

Learn More

• A/R Management

• Charge Management Rules

• Denial Analysis Report

• Encounters by Status List

• Executive Summary Report Overview 

• Executive Summary Report Calculations

• Executive Summary Report Use Cases

• Incomplete Charge Review

• Interactive Aging

• Missing Encounters Report

• Payments and Adjustments Report

• POPS Overview

• Statement Profile Setup