We are currently updating the OP Help Center content for the release of OP 14.19 or "OP 19". OP 19 is a member of the certified OP 14 family of products (official version is 14.19.1), which you may see in your software (such as in Help > About) and in the Help Center tabs labeled 14.19. You may also notice that the version number in content and videos may not match the version of your software, and some procedural content may not match the workflow in your software. We appreciate your patience and understanding as we make these enhancements.

Standard Reports: Compare Allowable to Payment

Version 14.19

When to Use this Report

Use this report to view your reimbursement values from your payers vs what your contracted allowable rates are. Users can easily see in the column Allowable Difference if they are seeing a trend of less or more for reimbursements.  

About Compare Allowable to Payment

Path: Reports menu > Standard Reports > Choose a Report dropdown > Compare Allowable to Payment

This report shows the estimated reimbursement/payer allowable for a charge along with the actual amount of payments from the insurance company.   

Note: There is a year limit for the date range. If the date range of the start date and end date is greater than 365 days, the end date will be modified to be a year later than the start date.


Note: More columns are available in the data grid than shown in the map below. The map only describes the columns displayed in the map. To see the total list of columns, select the column selection icon in the upper-left area of the grid ().

Compare Allowable to Payment Map

Number

Section
Description

1

Choose a report

The Choose a report dropdown selects one of the six available reports to display in the standard reports grid. These reports include:


2

Reference dates (range)
The Reference Dates set the start and end date for the displayed report’s date range. Reports that meet the criteria and fall within the selected date range will appear in the standard reports grid.

3

Refresh button
The Refresh button refreshes the data in the standard reports grid.

4

Print Grid button
The Print Grid button prints or exports the standard reports grid as it appears. You can print a paper or PDF copy of the report. The report will open in Print Preview mode. In Print Preview mode, you can choose to print the report or export to PDF.  If you export to PDF, you will be given some options regarding how you would like to save the image. Remember, that when saving practice sensitive information or any kind of PHI outside of Office Practicum, you should consider who has access to the information you are saving. You can add a password to the PDF you are saving by going to the Security tab, checking the box that says "Enabled," and Adding a User Password (or you can choose to protect your data in some other way within your own network).

5

Export button
The Export button exports the data shown in the standard reports grid as an .xls or .csv file.
6
Reset Preferences button
The Reset Preferences button resets the default window and grid preferences.

7

Preferences button
The Preferences button saves the window and grid preferences.
8
Rendering Provider
The Rendering Provider lists the name of the provider for the transaction.
9
Billing Provider
The Billing Provider lists the name of the billed provider on the claim.
10
Location
The Location column displays the location where the encounter occurred. This is useful for practices that have multiple locations.
11
Insurance Carrier
The Insurance Carrier column indicates the primary insurance carrier that was used for the patient on the selected date of service.
12
Date of Service
The Date of Service column lists the date of service for the indicated transaction.
13
CPT Code
The CPT Code column lists the medical code for the visit on the date of service.
14
CPT Description
The CPT Description describes the medical code provided in the CPT Code column.
15
Charge
The Charge column displays the total charges from the provider for the selected transaction.
16
Insurance Payments
The Insurance Payments column displays the amount paid by the insurance carrier.
17
Patient Payments
The Patient Payments column displays the total amount paid by the patient.
18
Insurance + Patient Payments
The Insurance + Patient Payments column displays the total amount paid by the insurance carrier and the patient (adding the Insurance Payments and Patient Payments columns together).
19
Payer Allowable
The Payer Allowable column indicates the contractually allowable charge as indicated by the insurance carrier.
20
Allowable DifferenceThe Allowable Difference column indicates the difference in the amounts between the Insurance + Patient Payments column and the Allowable Amount column.  
Version 14.10

When to Use this Report

Use this report to view your reimbursement values from your payers vs what your contracted allowable rates are. Users can easily see in the column Allowable Difference if they are seeing a trend of less or more for reimbursements.  

About Compare Allowable to Payment

Path: Reports menu > Standard Reports > Choose a Report dropdown > Compare Allowable to Payment

This report shows the estimated reimbursement/payer allowable for a charge along with the actual amount of payments from the insurance company.   

Note: There is a year limit for the date range. If the date range of the start date and end date is greater than 365 days, the end date will be modified to be a year later than the start date.


Note: More columns are available in the data grid than shown in the map below. The map only describes the columns displayed in the map. To see the total list of columns, select the column selection icon in the upper-left area of the grid ().

Compare Allowable to Payment Map

Number

Section
Description

1

Choose a report

The Choose a report dropdown selects one of the six available reports to display in the standard reports grid. These reports include:


2

Reference dates (range)
The Reference Dates set the start and end date for the displayed report’s date range. Reports that meet the criteria and fall within the selected date range will appear in the standard reports grid.

3

Refresh button
The Refresh button refreshes the data in the standard reports grid.

4

Print Grid button
The Print Grid button prints or exports the standard reports grid as it appears. You can print a paper or PDF copy of the report. The report will open in Print Preview mode. In Print Preview mode, you can choose to print the report or export to PDF.  If you export to PDF, you will be given some options regarding how you would like to save the image. Remember, that when saving practice sensitive information or any kind of PHI outside of Office Practicum, you should consider who has access to the information you are saving. You can add a password to the PDF you are saving by going to the Security tab, checking the box that says "Enabled," and Adding a User Password (or you can choose to protect your data in some other way within your own network).

5

Export button
The Export button exports the data shown in the standard reports grid as an .xls or .csv file.
6
Reset Preferences button
The Reset Preferences button resets the default window and grid preferences.

7

Preferences button
The Preferences button saves the window and grid preferences.
8
Rendering Provider
The Rendering Provider lists the name of the provider for the transaction.
9
Billing Provider
The Billing Provider lists the name of the billed provider on the claim.
10
Location
The Location column displays the location where the encounter occurred. This is useful for practices that have multiple locations.
11
Insurance Carrier
The Insurance Carrier column indicates the primary insurance carrier that was used for the patient on the selected date of service.
12
Date of Service
The Date of Service column lists the date of service for the indicated transaction.
13
CPT Code
The CPT Code column lists the medical code for the visit on the date of service.
14
CPT Description
The CPT Description describes the medical code provided in the CPT Code column.
15
Charge
The Charge column displays the total charges from the provider for the selected transaction.
16
Insurance Payments
The Insurance Payments column displays the amount paid by the insurance carrier.
17
Patient Payments
The Patient Payments column displays the total amount paid by the patient.
18
Insurance + Patient Payments
The Insurance + Patient Payments column displays the total amount paid by the insurance carrier and the patient (adding the Insurance Payments and Patient Payments columns together).
19
Payer Allowable
The Payer Allowable column indicates the contractually allowable charge as indicated by the insurance carrier.
20
Allowable DifferenceThe Allowable Difference column indicates the difference in the amounts between the Insurance + Patient Payments column and the Allowable Amount column.