From Registration to Accounts Receivable – The Whole Can of Worms 2007 UBO/UBU Conference 1 Briefing:How to Use Management Reports Part 1 - TPC Date:22 Mar 2007 Time:

2007 UBO/UBU Conference From Registration to Accounts Receivable 2 Objectives Run the right reports Determine the best time to run them Know how to calculate the numbers Know how to identify problem areas

2007 UBO/UBU Conference From Registration to Accounts Receivable 3 Outpatient reports needed: – Summary by Clinic – Accounts Receivables by Patient – Accounts Receivables by Month – DD 2570 Program Results – Positive Balance – Negative Balance Outpatient Reports

2007 UBO/UBU Conference From Registration to Accounts Receivable 4 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

2007 UBO/UBU Conference From Registration to Accounts Receivable 5 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

2007 UBO/UBU Conference From Registration to Accounts Receivable 6 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

2007 UBO/UBU Conference From Registration to Accounts Receivable 7 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

2007 UBO/UBU Conference From Registration to Accounts Receivable 8 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

2007 UBO/UBU Conference From Registration to Accounts Receivable 9 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

2007 UBO/UBU Conference From Registration to Accounts Receivable 10 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

2007 UBO/UBU Conference From Registration to Accounts Receivable 11 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

2007 UBO/UBU Conference From Registration to Accounts Receivable 12 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