Advanced Reporting - RCM Insights

The RCM Insights dashboard provides a comprehensive overview of the key performance indicators (KPIs) and metrics related to Revenue Cycle Management, such as Average Days to Pay and Claim Denial Rates. These insights can help drive strategic decision making for your practice throughout the billing lifecycle. 

Viewing the dashboard

Click Reports.

Select All

 

Click RCM Insights under the Advanced Reporting section.

 

Understanding the dashboard

The dashboard is organized into four (4) tabs, allowing you to view data based on different encounter criteria, including the Initial Billed Date, Service Date, Batch Date, and Encounter Created Date. 

In its default state, the dashboard will include information for the entire practice. However, the dashboard can be filtered by Rendering Provider, Places of Service, Billing Providers, Scheduling Providers, Financial Class Names, Payer Names, Billing Event types, or a combination of all listed filters. Click here to learn more about filtering Advanced Reports.

  

 




Unpaid claims

The Unpaid Claims graph provides an overview of outstanding monthly claim balances for the timeframe selected. This section allows you to track and monitor outstanding balances, enabling you to identify trends and take necessary action to resolve any issues related to unpaid claims. 

The top Unpaid Claims box indicates the overall total of unpaid claims for the timeframe.

 

The bottom box, on the other hand, displays the increase or decrease in unpaid claims over the most recent two (2) months. The Unpaid Claims section of the dashboard provides a comprehensive overview of the unpaid claims trend, allowing you to analyze and understand the variations in the total amount of unpaid claims over the selected timeframe. 

 

You can also select specific months in the Unpaid Claims graph. For example, if you selected the timeframe of January 2023 to June 2023, you can compare March and April’s data specifically by clicking directly on the March and April bars on the graph. In doing so, the Unpaid Claims boxes are now comparing those two months. Additionally, this selection filters the entire dashboard to solely show you information on March and April of 2023. To no longer compare those months, simply select “Clear Filter” in the top left of the graph. Click here to learn more about interacting with the graphs in Advanced Reporting.

 

Unbilled charges

The Unbilled Charges graph provides an overview of any claims that have yet to be billed to the payer. In other words, these claims are missing an Initial Billed date in the system.This grid serves as a valuable management tool for tracking and monitoring pending billing transactions.

 

The top Unbilled Charges box indicates the overall total of unbilled charges. 

 

The bottom box, on the other hand, displays the increase or decrease in unbilled charges over the most recent two (2) months. The Unbilled Charges section of the dashboard provides a quick snapshot to help you identify any claims that are still pending being sent to the payer.

 

You can also select specific months in the Unbilled Charges graph. For example, if you selected the timeframe of January 2023 to June 2023, you can compare March and April’s data specifically by clicking directly on the March and April bars on the graph. In doing so, the Unbilled Charges boxes are now comparing those two months. Additionally, this selection filters the entire dashboard to solely show you information on March and April of 2023. To no longer compare those months, simply select “Clear Filter” in the top left of the graph. Click here to learn more about interacting with the graphs in Advanced Reporting.

 

Total encounters

The Total Encounters graph displays the total number of encounters for the selected timeframe, as well as a trend of monthly encounter totals over the selected timeframe. 

 

Average days to pay

The Average Days to Pay graph calculates the average time it takes for payers to submit payment. The graph displays the average number of days between the initial billed date and the payment date for the payers selected in the filter at the top of the dashboard. If you’d like to see the Average Days to pay for a specific payer, select that payer only in the filter above. This section of the dashboard helps set workflow timelines for payer follow-up.

 

Claim lag time

The Claim Lag Time graph calculates the average time between the date of encounter creation and the date of initial billing. The graph helps to identify if there are any delays in the billing process for claims, which can cause delays in reimbursement.

 

The five (5) boxes at the bottom of the screen display the ratio and rate of your claim statuses. The ratio represents the percentage of claims that have been successfully processed, while the rate represents the number of claims processed. 

  • Clean Claims Ratio - Displays the percentage of billed claims that weren’t errored or rejected.
  • Claim Denial Rate - Displays the percentage of billed claims that were denied..
  • First Pass Yield Ratio - Displays the percentage of paid claims that were not rejected or denied.
  • Bad Debt Ratio - Displays the percentage of billed claims that were sent to bad debt.
  • Resolve Rate - Calculates the total payments received for the timeframe divided by the total charges for the timeframe. 

 

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