Version 21.3

When to Use this Report

Use this report to view a summary of billing data, determining the average reimbursement of CPT codes. Commonly used for Payment history by CPT, Insurance payment monitoring, and Payment history by provider.

Note: Voids are recorded when transactions are daysheeted. If a transaction is current and not daysheeted, there is no void that is recorded. It is very important to daysheet on a regular basis to keep the financial integrity of the system.

About Reimbursement Analysis

Path: Tools > Reporting > Monthly Reports > Reimbursement Analysis

The Reimbursement Analysis Report is a summary of billing data. It is best used when determining the average reimbursement of CPT codes. The data in this grid reflects the transactions that have been posted. The data selection can be based on a range of dates by either date of service or posted date. Only charge transactions are shown. Payment and adjustment transactions that have been applied to a charge are shown as summarized totals.

Reimbursement Analysis Map

Hover over each of the Summary Tiles, to see specific data. For instructions on how to drill down and expand that information from the Summary Tiles, please see the Drill Down section of the Data Element Tutorial.

Note: All columns in the Detailed Report section will show by default. To hide columns, see the Visualization section of the Maximized Elements article.

Filters and Summary Tiles

Number	Section	Description
1	Date of Service (DOS)	This is the date the service was performed. Select the date(s) for the displayed record's date range. Items that meet the criteria and fall within the selected date range will appear in the detailed reports grid. See the Dates section of the Filter Tutorial article for the different selections.
2	Rendering Provider	Use this filter to select the provider(s) who performed the service for the appointments.
3	Posted Date	Select the date(s) to display the transactions for the posted date selected AS LONG AS they were also daysheeted. See the Dates section of the Filter Tutorial article for the different selections.
4	Paid Status	Use this drop-down to filter the report by the Paid Status of the transactions. Click the radio button to show only those transactions (Fully Paid, Insurance Paid, Patient Paid, All, Insurance Owes, or Patient Owes).
5	Daysheet Date	This is the effective Daysheet date. Select the date(s) for the displayed record's date range. Records that meet the criteria and fall within the selected date range will appear in the detailed reports grid. See the Dates section of the Filter Tutorial article for the different selections.
6	Include Voids	Use this drop-down to select whether or not you want to include voided transactions in this report.
7	Total Charges	The Total Charges Summary Tile displays the total amount of charges for the combined services rendered.
8	Patient Balance	The Patient Balance Summary tile displays the total Patient balance on all transactions included in the report (totals from the Patient Balance column).
9	Insurance Balance	The Insurance Balance Summary tile displays the total Insurance balance on all transactions included in the report (totals from the Insurance Balance column).
10	Insurance Paid	This Summary tile shows the total amount paid by the insurance carrier in the filtered report (totals from the Insurance Paid column).
11	Total Patient Paid	This Summary tile shows the total total amount paid by the patients in the filtered report (totals from the Patient Paid column).

Detailed Report

Number	Section	Description
a	Rendering Provider	The Rendering Provider lists the name of the provider for the transaction. Expand or collapse the providers to view the services associated with each.
b	Date of Service (DOS)	The Date of Service (DOS) column lists the date of service for the indicated transaction.
c	Posted Date	The Posted Date column displays the date the indicated transactions were posted.
d	Daysheet Date	The Daysheet Date column displays the date that the daysheet was created.
e	Claim #	The Claim # column displays the number for the claim where the transaction occurred.
f	Patient	The Patient column displays the patient's first and last name and the patient identifier for the indicated transaction.
g	Date of Birth	This column shows the date of birth for the patient.
h	CPT	The CPT code column lists the medical code for the visit on the date of service, and it's description.
i	Charge	The Charges column displays the total charge for the service rendered for that particular patient.
j	Patient Owed	The Patient Owed column indicates the amount that the patient owes for this particular transaction.
k	Patient Paid	The Patient Paid column displays the total amount paid by the patient.
l	Patient Adjustment	The Patient Adjustment column indicates the amount of the charge adjustment that was written off for a particular CPT code.
m	Min. Patient Payment	This column shows the minimum amount your practice has received for a patient payment.
n	Max. Patient Payment	This column shows the maximum amount your practice has received for a patient payment.
o	Patient Balance	The Patient Balance column shows the balance the patient has yet to pay for the indicated service.
p	Patient Average Pay	This column shows the average amount your practice has received for a patient payment.
q	Insurance Paid	The Insurance Paid column displays the amount paid by the insurance carrier.
r	Insurance Adjustment	The Insurance Adjustment column indicates the amount the insurance adjusted.
s	Min. Insurance Payment	This column shows the minimum amount your practice has received for an insurance payment.
t	Max. Insurance Payment	This column shows the maximum amount your practice has received for an insurance payment.
other	Insurance Balance	The Insurance Balance column shows the balance the Insurance has yet to pay for the indicated service.
other	Insurance Avgerage Pay	This column shows the average amount your practice has received for an insurance payment.
other	Total Collected	The Total Collected column displays the total amount collected by the Patient and the Insurance (total from Insurance Paid and Patient Paid column).
other	Average Collected	The Average Collected column displays the average amount collected by the Patient and the Insurance for this CPT code.
other	Location Name	The Location column displays the location where the encounter occurred. This is useful for practices that have multiple locations.
other	Ins. Balance Calculated	This column shows the calculated balance for the Insurance based on the insurance payments and adjustments.
other	Pat. Balance Calculated	This column shows the calculated balance for the patient based on the patient payments and adjustments.
other	% Charges Paid	This column shows the percentage that was paid out of the total charges (Total Collected column / Charge column)
other	Primary Insurance	The name of the Primary Insurance that was used for the patient on the selected date of service.
other	Billing Provider	The Provider with Billing credentials associated with performing the service.
other	DX Code	This column lists the DX Code associated with the claim.
other	Entered by Staff	The name of the staff member who entered this transaction
other	Daysheet Date (Month)	The Daysheet Date column shows the month and the year that this transaction was daysheeted.
other	Include Void	This column indicates if the transaction is a voided one or not.

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