Step 8: Chapter 9 - Practice Revenue Reporting

Training Video
Practice Revenue Reporting

Reports Available
Eight categories of reports can be generated at any time in Report . All offices, whether big or small, can only determine their worth, efficiency, and productivity by producing reports. Next, you must understand the data that is produced and what it represents. Each category has many specific reports, and each category will summarize the purpose of the possible reports. Financial reporting is part of the practice revenue cycle and should be performed daily, weekly, monthly, and yearly. For your assignment, at the end of each module, when all your patient, claim, and payments have been entered, generate the following nine reports and experience the value of practice revenue cycle financial reporting.

Many reports have been suggested in the previous chapters. These are additional reports to generate and enhance your experience of financial reporting.

The following report tree lists eight report categories with several reports listed under each.

Financial Reports to Generate

Below are descriptions of the ten recommended reports to generate as part of enhancing your practice revenue cycle experience. At the end of completing your ClaimGear assignment, generate each report and remember to change all the date filters to All.

 1. A/R Aging Summary by Payer Type Breakdown tab
                This report lists outstanding charges due to insurance by aging bracket (e.g. 0-30 days past due). Generate this report and   
             determine which Payer type has the most outstanding balance?

  2. Activity Summary
              This report gives a summary of all charges, debits, insurance adjustments, insurance payments, and patient payments. Generate                  this report to determine how much you billed insurance companies. What percentage do you adjust? Which provider did you bill                  the most for? Which collected the most payments by insurance?

   3. Charges Due Insurance by Date Range
                This report lists the payer(s) with the patient and amount owed to the provider. Is there a patient whose insurance still has a                        balance? Who is the patient?

    4. All Patients Seen – Charge Details
                This detailed report lists by patient, the details of the patient and insured information, with the charge payments and adjustment.

    5. Claims Entered Report
                This report lists all claims entered with the dates of service, claim amount, and patient. Run the report by billed to primary or
                secondary insurance, or by entered into the practice, or by charge date of service. Generate this report and cross-reference
                it with the Patient Listing in the workbook assignment. Make sure per patient, the claim date and number of claims matches the                    listing.

    6. Daily/Monthly Insurance Payments/Adjustments
                This report provides a main table and specific topics such as by Provider or by Payer. Use this report and determine which
                provider was billed the most and least, and which had the most/least adjustment amount? Who brings more money to the

    7. Payments Received by Charge Date
                This report lists the total paid per payer name, with the dates of the charges and payments received and entered. Generate this                     report and determine which insurance company paid the highest amount.

    8. Referring Physician Statistics
                This report lists per referring provider, the charge code and charge amount with payment information. Generate this report and                    determine which referring provider brought the most insurance payments to the practice.

    9. Patient Deductible Report
                This report will list all the patients with the deductible amount owed. Generate this report and even create a global alert on each                    patient’s account to collect this amount during the next appointment.

    10. Patient Listing
                This report will list all the patients that have been entered into the database.  It will list the name spelling, date of birth, date of
                service, and if multiple patient entries.  Generate this report to assist in the Claim Not Found error.

Practice Revenue Cycle Activities: Financial Reporting 

The practice revenue cycle activities are a combination of discussion questions and activities using ClaimGear and its workbook .

Financial reporting is the mathematical way to determine the success of the practice. The timing of reports varies by specific report, and can be daily, weekly, monthly, and yearly. In addition to generating the reports as part of an assignment, complete the following tasks to further enhance your revenue cycle experience as it relates to your current ClaimGear

        1.     Did you customize the report table?
                        a.    For example, you can reorganize the columns by clicking on the header and moving it to the right/left in a                                                       more appropriate spot.
                        b.    Did you reorder the data by clicking on a column header for your preference?
                        c.    What can you determine from each report?
        2.     Students experienced with Excel may export the report data into Excel and produce a graph.
        3.     Who in the practice is responsible for generating the different types of reports? How frequently? How could the results be used to                 improve the job function of the person in charge and increase the practice revenue?
        4.     In your prospective career, how many times will you need to generate reports? Make sure you understand the reports necessary                 for your job function.

How to Generate a Report
To generate a report:
        1.     Double click the report you want to generate. For this example, the A/R Aging Summary.
        2.     A smaller window opens asking for more information, which varies depending on the report. For this example, change the
                date ranges to “All.”
        3.     After you have selected the filters needed, click the OK button.

Customize the Reports
When the report displays, the versatile table can be adjusted to display only the columns you desire. It also can organize the column
data alphabetically or numerically by clicking on the column header. For example, the main table lists the data numerically
by the patient account number.

Many would prefer to see this information by patient name alphabetically. To accomplish this, click on the column header “Patient
Full Name” and you will see how the data is reordered.

Often, you’ll need to hide extra information. To accomplish this, right-click on the column header and choose hide.

Print Reports

You can choose to print the report by clicking the Print Report button, or leave the report and continue on with your assignment.

You will need to click Print a total of three times before printing actually occurs. The following three screens will highlight the
various positions of the Print button.

1. Once you have the report generated and you want it to print, click the Print button.

2. The Printer selection screen will display. Click the Print button.

3. The Print Preview screen will display. It is important to choose the correct filters prior to clicking print.
  •         Orientation: Landscape
  •         Report Header: Every page
  •         Page Breaks: New page per table
  •         Item Selection: Do you want all the tabs/tables or just the main table?
  •         Click the Print button

Example 1: “Patient Listing” report

Example 2: “Charge Overview by Date Range” report

Complete the EOB Breakdown

The last task for each ClaimGear assignment is to complete an EOB Breakdown. The purpose of this table is to learn how to manually record insurance and patient payment information and to become familiar with the various insurance industry terms and calculations.

For each patient in the assignment, you will complete one line with the given financial information.

To complete the EOB Breakdown, the first two columns are entered for you, Patient Name and Date of Service. There is one line per patient, so when a patient has multiple claims, you must add all the visit totals into the one field. You will enter the amounts in each field, retrieving the information one of three ways. NOTE: All information may not be available on the EOB. For the fields with missing data, utilize the formulas on the EOB Breakdown to assist you in calculating these amounts. See the following steps and example:

        1. Retrieve in ClaimGear , the patient EOBs, and extract the totals.
        2. Locate in the workbook 
 the patient EOBs and calculate the totals on one line.
        3. Generate the “Charge Overview by Date Range” report, which instantly totals per patients the batch information. This is the
            easiest and quickest method.

Details of "Charge Overview by Date Range" Report

The Claim Report “Charge Overview by Date Range” is your electronic verification that you posted all payments correctly.

It can be generated by going to Report , Claim Reports, and Charge Overview by Date Range.


The report displays and contains information per patient (all claims listed individually and combined), the CPT, DOS, Charges,
Insurance Paid, Patient Paid, Adjustments, and Balance. It also totals for the patient on the first line with the bold patient name, a
combined amount of all the claim totals.

Here is Rocky Shore. You can see all the charges for patient Steven Allsop. Notice the top line in bold, patients name, and the total
of his amounts. What is shown on the screen may not be all the information; you must pay attention to the scrolls on the bottom and
right side of the screen.

Remember when printing this report to select the correct filters as previously mentioned.

How to Cross-Reference the Report with Your Written EOB Breakdown Answers

When comparing both 1. EOB breakdown you completed and 2. ClaimGear report “Charge Overview by Date Range,” the totals should match perfectly. If there is a discrepancy, it indicates one of your methods contains an error and you will need to research the problem and fix the error accordingly.

Here is how to cross-reference your data; the totals of the “Charge Overview by Date Range” should match your written totals on
the EOB Breakdown.

                                                                                  EOB Breakdown             billed-adjusted
                                                                            “Charge Overview by Date Range” report.