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From Registration to Accounts Receivable – The Whole Can of Worms

2007 UBO/UBUConference

Briefing: How to Use Management Reports

Part 1 - TPC

Date: 22 Mar 2007

Time: 0800 - 0850

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2007 UBO/UBU ConferenceFrom Registration to Accounts Receivable Objectives

Run the right reports

Determine the best time to run them

Know how to calculate the numbers

Know how to identify problem areas

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2007 UBO/UBU ConferenceFrom Registration to Accounts Receivable

Outpatient reports needed:– Summary by Clinic– Accounts Receivables by Patient– Accounts Receivables by Month– DD 2570 Program Results– Positive Balance– Negative Balance

Outpatient Reports

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2007 UBO/UBU ConferenceFrom Registration to Accounts Receivable Outpatient Reports

Summary by Clinic shows billing and collection activity by MEPRS code

Shows clinic billings with excessive write-offs Data can be used by the clinics as EPR material and

incentive to collect more insurance information For AF facilities, ensure numbers match what the

billing contractor is reporting The data from this report may be submitted monthly up

the chain of command. For AF facilities, the AF 178 is submitted to the squadron commander

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2007 UBO/UBU ConferenceFrom Registration to Accounts Receivable Outpatient Reports

Outpatient Accounts Receivables by Patient provides a detailed list of all open outpatient claims

Analyze and trend the age of the open claims; both by dollars and by number of claims

Address problem areas like aging A/R, or too many unpaid claims from one clinic or one patient

Data is reported monthly in the Budget Execution Report by AF facilities

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2007 UBO/UBU ConferenceFrom Registration to Accounts Receivable

Accounts Receivables by Month provides a total of all write offs, refunds, payments, reversed payments, billings, and reversed billings

The total ending balance for all pages of this report should equal the A/R by Patient total

Use this report to identify problem areas

Outpatient Reports

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2007 UBO/UBU ConferenceFrom Registration to Accounts Receivable

The DD 2570 Program Results Report provides information on billings, collections, and write offs for the entire fiscal year

The report can show increases or reductions in billings or collections

It can identify excessive use of a write-off code The total open claims less those in “U” status should

equal the total shown on the A/R by Patient report and the A/R by Month report

Last month’s total A/R plus billings, less payments, less write offs from the Summary by Clinic report should also equal this amount

Outpatient Reports

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2007 UBO/UBU ConferenceFrom Registration to Accounts Receivable

The Positive Balance Report reflects claims which had a payment posted but were not written off or closed

This report, along with your EOBs, can be used to make follow-up calls to the insurance company on questionable write-offs

Most write-offs that accompany payments can be posted immediately, so this report should be very short each month

The Negative Balance Report reflects claims that were closed for more than the billed amount, or a write-off was posted twice. This normally occurs when the TPOCS server experiences problems during the posting process

Problem claims may need to be wiped out, rebilled, reposted, and written off

Outpatient Reports

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2007 UBO/UBU ConferenceFrom Registration to Accounts Receivable

Inpatient reports needed– Accounts Receivables by Patient– DD 2570 Program Results– TPC Monthly Activity Report– TPC Monthly Medical Services Activity

Reconciliation Report– Insurance Notify Roster

Inpatient Reports

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2007 UBO/UBU ConferenceFrom Registration to Accounts Receivable

Inpatient Accounts Receivables by Patient is similar to the outpatient report, except additional information is provided

It’s best to spool this report in CHCS, download it and convert it to an Excel file, then sort by the date billed

If this can’t be done, print the report, then manually enter the data in a spreadsheet

Additional information is included on this report

Inpatient Reports

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2007 UBO/UBU ConferenceFrom Registration to Accounts Receivable

The Inpatient DD 2570 Report should be printed monthly

This data is reported quarterly The Inpatient Monthly Medical Services Activity Report

gives totals for billings, postings, and write-offs for the month

The Inpatient Medical Services Reconciliation Report provides detailed information

The Insurance Notify Roster identifies claims that have changed

Inpatient Reports

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2007 UBO/UBU ConferenceFrom Registration to Accounts Receivable Summary

Together, these reports can give a clear picture of how well your TPC program is running

They can identify problem areas They show trends If you work these reports monthly, you can eliminate

problems before you need to submit quarterly reports online