Briefing: How to Use Management Reports Part 1 - TPC Date: 22 Mar 2007

Briefing: How to Use Management Reports Part 1 - TPC Date: 22 Mar 2007 Time: 0800 - 0850

Objectives • Run the right reports • Determine the best time to run them • Know how to calculate the numbers • Know how to identify problem areas

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

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

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

Outpatient Reports • 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 • 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 • 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

Inpatient Reports • 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 • 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 • 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

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

Briefing: How to Use Management Reports Part 1 - TPC Date: 22 Mar 2007