Reference Guide - Sutter Community Connect

Practice Management Reports

Reference Guide

Practice Management Reports v2015

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Table of Contents By Section

Editor’s note: If using the electronic version, please use the following table of contents to quickly jump to the desired topic area. This will help expedite your search for specific/detailed advice.

Billing/Revenue Reports................................................................................................ 4

Cadence/Prelude Reports ........................................................................................... 43

Ambulatory Reports .................................................................................................... 51

BI Launch Pad Reports ............................................................................................... 59

This document and related materials, including emails, letters, and other correspondence, contain proprietary and confidential information of Sutter Health and Sutter Physician Services; and shall not be used, disclosed, reproduced or otherwise made available, in whole or in part, for any purpose other than for the purpose provided under the Non-Disclosure and Confidentiality Agreement between the parties, without the prior express written consent of Sutter Health and Sutter Physician Services. This document, related materials, and all information contained herein remains at all times the sole property of Sutter Health and Sutter Physician Services.


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Billing/Revenue Reports


Monitoring the Revenue Cycle ...................................................................................... 5

Resolute Professional Billing Reports – Financial Metrics ............................................. 6

Revenue Management Report ...................................................................................... 6

My Practice – Charge Capture tab .............................................................................. 13

My Practice – Insurance tab ........................................................................................ 15

My Practice – Self-Pay tab .......................................................................................... 18

My Practice – Un-posted Cash tab .............................................................................. 20

My Practice – Credit Balances tab .............................................................................. 21

PB Community Connect Financial Metrics .................................................................. 23

PB Workqueue Monitoring Report ............................................................................... 24

PB Aged Accounts Receivable ................................................................................... 25

PB Daily Payments and Refunds ................................................................................ 26

Follow-Up Workqueue Payor Lag Time Report ........................................................... 27

Follow-Up Workqueue Summary Report ..................................................................... 28

User Activity Summary ................................................................................................ 29

Claim Run Info Report ................................................................................................ 31

Claim Run Tracking Report Template ......................................................................... 33

Claim Edit Workqueue User Productivity Report ......................................................... 34

Cash Drawer Closing Detail Report ............................................................................ 36

Encounter Form Control Report .................................................................................. 37

All User Batch Report ................................................................................................. 38

Generic Transaction Search ....................................................................................... 39

Guarantor Account Search Report .............................................................................. 40

Daily Production Summary Report .............................................................................. 41

Billing Procedures by Provider .................................................................................... 42


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Monitoring the Revenue Cycle

Prepare your practice to have the revenue cycle go live over a 90-day period. Plan to use new tools, workflows, and reports throughout this period. You need to set expectations with the staff when a new area of the revenue cycle is approaching so they are aware of the workqueues to monitor and work. For example, when you receive your first remittance from insurance, have users review their insurance follow-up workqueues to see what responses or denials were received from the payor.

Run through the expectations of each area of the revenue cycle before go-live. Based on your proposed timeline, see if you are successfully meeting your target dates post go-live. If you are not, use the reports mentioned in the Professional Billing Reports section to investigate where the AR is being caught.


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Resolute Professional Billing Reports – Financial Metrics Revenue Management Report Key Business Metrics: AR Balance, Insurance AR, Self-Pay AR, Pre-AR, Daily AR, Weekly AR, and Monthly AR including: Charges per month for the past 12 months (in dollars), payments per month for the past 12 months (in dollars), adjustments per month for the past 12 months (in dollars)

Report Description: This report helps you monitor, at a high level, the accounts receivable (AR) for a given service area (usually a single community practice). Revenue is divided between pre-AR, pending claims, pending insurance payments, pending statements, outstanding statements, and credit balances. There are three columns that appear across most sections: Count, Amount, and Percent.

Count: The number of claims/statements/charges/charge sessions/etc. that qualify for the measurement or detail on the left.

Amount: The dollar amount represented by the measurement or detail on the left.

Percent: The dollar amount for the row divided by the total for the measurement or detail.

Why should I run it? This report helps you quickly see what areas of the revenue cycle are performing as expected and what areas require additional research and investigation. This is the first report you run daily to monitor the practice's financial health. This report also shows whether charges, payments, and adjustments are on track and allows you to spot financial trends from day-to-day, week-to-week, or month-to-month. The report displays gross charges, payments, and net adjustments posted in each month in the year.

Where can I find it? In Hyperspace: Epic button > Reports > Professional Billing Reports > Revenue Management Report

How often should I run it? Daily

What to look for:

Note: Click a blue hyperlink to jump into the detail section for that metric

Compare total AR before go-live and the totals in this report to the percentage of AR that is in Epic.

Determine the ratio of self-pay to insurance AR for the practice. Monitor this percentage in the AR Snapshot section.

Compare Epic charge, payment, and adjustment trends to your pre-live metrics (as well as goals of where they should be, if different).

If the data does not meet your organization’s goals, follow up on problematic charges, payments, or adjustments using reports that provide more detail about that area of the revenue cycle.

Determine the level of monthly denials expected based on pre-live levels. Use the Denials section to compare denial volumes and to have a starting point to address fluctuations and issues.


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AR Snapshot

Pre AR Snapshot

Charge Router


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Outstanding Insurance Debits Details

AR Details


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Charge Review Details by Rule

Charge Review Details by Workqueue

Claim Edit Details


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Claim Edit Details by Workqueues

Claims Outstanding Details

Claims Pending Details


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Follow-up Workqueues

Undistributed Credits Details

Daily/Weekly/Monthly AR


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Adjustments by Categories

Denials

Daily/Weekly Claim Volumes


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My Practice – Charge Capture tab Key Business Metrics: Open encounters, encounters without charges, charge router & charge review quantities and totals broken down by provider.

Report Description: Billing office managers and other supervisors can use the My Practice Charge Capture tab to monitor their organization's pre-AR numbers and flow. The page is set up to show segments related to encounters that providers still have open (which cannot be billed for yet), charge router, charge review workqueues.

Why should I run it? This view helps you quickly see what areas of the pre-AR revenue cycle are performing as expected and what areas require additional research and investigation.

Where can I find it? Epic button > Professional Billing > My Practice > Charge Capture tab


What to look for: The columns shown in the “Encounters Without Charges” section display the number of encounters that any given provider for your practice currently has not yet closed as well as the number of encounters that have been closed but no charges associated yet. An excessive number, (to be determined by your practice), may warrant investigation. Clicking on the hyperlinked numbers will take you to a list view of the patients and visits that constitute the numbers.


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The “Charge Router and Charge Review” section display the number and dollar totals of encounters currently in the Charge Router workqueue, (those encounters with large errors), as well as encounters currently in Charge Review workqueue, (those encounters with more detailed errors). Note: All encounters stop in the Charge Review workqueue to allow billers to verify the coding and claim information prior to the claim being sent out. An excessive number, (to be determined by your practice), may warrant investigation. Clicking on the hyperlinked numbers will take you to a list view of the patients and encounters that constitute the numbers.


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My Practice – Insurance tab Key Business Metrics: Pending claims, claim errors, outstanding claims, denied claims & all current insurance balances.

Report Description: Billing office managers and other supervisors can use the My Practice Insurance tab to monitor their organization's insurance balances and revenue cycle flow. The page is set up to show segments related to insurance balances and claim edit workqueues.

Why should I run it? This view helps you quickly see what areas of the revenue cycle with respect to insurance payers are performing as expected and what areas require additional research and investigation.

Where can I find it? Epic button > Professional Billing > My Practice > Insurance tab


What to look for: The Summary section display (by provider) the dollar amount of pending claims, claim errors, outstanding claims, denied claims and claims with no status’. An excessive amount, (to be determined by your practice), may warrant investigation. Clicking on the hyperlinked numbers will take you to a list view of the patients and claims that constitute the numbers.

The Claim Errors by Age section allows a practice manager to see how long claims with errors have been waiting to be corrected. The information can be displayed by provider and then by payer, or by payer first and then by provider. An excessive amount, (to be determined by your practice), may warrant investigation. Clicking on the hyperlinked numbers will take you to a list view of the patients and claims that constitute the numbers.


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The Claim Errors by Error section allows a practice manager to see which errors are currently preventing the most money from being sent out to be paid as well as the age of the oldest error of that type. Trends can be more easily identified so that the root causes may be addressed. An excessive amount, (to be determined by your practice), may warrant investigation. Clicking on the hyperlinked numbers will take you to a list view of the patients and claims that constitute the numbers.

The Outstanding Claims section allows a practice manager to see a 30/60/90+ view of claims that have been sent to payers but have not received responses. The data may be viewed either by provider and then payer, or by payer and then provider. An excessive amount, (to be determined by your practice), may warrant investigation. Clicking on the hyperlinked numbers will take you to a list view of the patients and claims that constitute the numbers.

The Denied Claims section allows a practice manager to see a total of charges that have been denied by payers. The data may be viewed either by provider and then payer, or by payer and then provider. An excessive amount, (to be determined by your practice), may warrant investigation. Clicking on the hyperlinked numbers will take you to a list view of the patients and claims that constitute the numbers.


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The All Current Insurance Balances section allows a practice manager to see to total of all charges, both pre-AR and current AR that are currently unpaid. The data may be viewed either by provider and then payer, or by payer and then provider. An excessive amount, (to be determined by your practice), may warrant investigation. Clicking on the hyperlinked numbers will take you to a list view of the patients and claims that constitute the numbers.


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My Practice – Self-Pay tab Key Business Metrics: Outstanding self-pay balances aged out to 30/60/90/120/120+ and totals, list of accounts with returned mail, payment plan, collections and contested status’ and a list of pending statement runs.

Report Description: Billing office managers and other supervisors can use the My Practice Self-Pay tab to monitor their organization's self-pay balances and revenue cycle flow. The page is set up to show segments related to self-pay balances and guarantor account status’.

Why should I run it? This view helps you quickly see what areas of the revenue cycle with respect to self-payers are performing as expected and what areas require additional research and investigation.

Where can I find it? Epic button > Professional Billing > My Practice > Self-Pay tab


What to look for: The Outstanding Self-Pay section display (by provider) the dollar amount of charges currently outstanding, aged out 0-30, 31-60, 61-90, 91-120, 120+ and totals. An excessive amount, (to be determined by your practice), may warrant investigation. Clicking on the hyperlinked numbers will take you to a list view of the patients and the charges that constitute the numbers.

The Accounts with Status section displays a list of guarantor accounts who have had any of the following account status’ assigned: Returned Mail, Payment Plan, Collections, and Contested. It can be useful for a practice manager to see these different patient populations. Clicking on a patient’s name will direct you to the patient’s Guarantor Snapshot.


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The Pending Statement Runs section displays a list of patient statements that must be reviewed and accepted within Epic. Clicking on the hyperlinked statement run number will direct you to a window where you can view/accept your statement runs.


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My Practice – Un-posted Cash tab Key Business Metrics: Remittance and standard payment posting batches that are either currently open or have errors.

Report Description: Billing office managers and other supervisors can use the My Practice Un-posted Cash tab to monitor their organization's payment posting batches within the revenue cycle flow. The page is set up to show segments related to payment posting.

Why should I run it? This view helps you quickly see what areas of the revenue cycle with respect to payment posting are performing as expected and what areas require additional research and investigation.

Where can I find it? Epic button > Professional Billing > My Practice > Un-posted Cash tab


What to look for: The Payments with Errors section displays electronic remittance runs that currently have errors that must be resolved before posting can occur. An excessive amount, (to be determined by your practice), may warrant investigation. Clicking on the hyperlinked numbers will take you to a list of the remittance runs that constitute the numbers.

The Unprocessed Payment Batches section displays payment posting batches that currently are currently open and must be closed before payments can be posted to the accounts. An excessive amount, (to be determined by your practice), may warrant investigation. Clicking on the hyperlinked numbers will take you to the payment posting batch that constitutes the numbers.


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My Practice – Credit Balances tab

Key Business Metrics: Insurance and self-pay credits.

Report Description: Billing office managers and other supervisors can use the My Practice Credit Balances tab to monitor their organization's credit balances within the revenue cycle flow. The page is set up to show segments related to insurance and self-pay credit balances.

Why should I run it? This view helps you quickly see what areas of the revenue cycle with respect to credit balances are performing as expected and what areas require additional research and investigation.

Where can I find it? Epic button > Professional Billing > My Practice > Credit Balances tab


What to look for: The Insurance—Undistributed Credits section displays insurance payments that have been posted but not matched to charges. An excessive amount, (to be determined by your practice), may warrant investigation. Clicking on the hyperlinked numbers will take you to the transaction detail for that payment.

The Insurance—Charges with Credit Balances section displays charges that have an outstanding credit balance due to over-matching of insurance payments. An excessive amount, (to be determined by your practice), may warrant investigation. Clicking on the hyperlinked numbers will take you to the transaction detail for that payment.


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The Self-Pay—Undistributed Credits section displays self-pay payments that have been posted but not matched to charges. An excessive amount, (to be determined by your practice), may warrant investigation. Clicking on the hyperlinked numbers will take you to the transaction detail for that payment.


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PB Community Connect Financial Metrics

Key Business Metrics: Cumulative aging since go-live

Report Description: This report can show a breakdown of weekly or monthly total AR. It also includes Charge Review and Claim Edit Amounts and the % of AR that sits in the WQs.

Why should I run it? This report will summarize the AR if searched over a range and will provide a bucket breakdown by either Insurance, Self-Pay, or Total Aging.

Where can I find it? Reporting Workbench in Hyperspace: Epic button > Reports > My Reports > Library > PB Community Connect Financial Metrics

How often should I run it? Monthly

What to look for: Practice managers and billing managers can use this report to monitor AR trends at a high-level and to see Charge Review and Claim Edit Amounts all in one area.


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PB Workqueue Monitoring Report

Key Business Metrics: Workqueue start and current amounts

Report Description: This report is able to show aggregate information for all workqueues that the practice actively monitors and works

Why should I run it? Run this report to monitor for workqueues that are neglected, growing quickly, contain high priority items, and that are performing strongly.

Where can I find it? Reporting Workbench in Hyperspace: Epic button > Reports > My Reports > Library > PB Workqueue Monitoring

How often should I run it? Monthly, Weekly

What to look for: Workqueues that have little activity and that have a start and current count with little variance


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PB Aged Accounts Receivable

Key Business Metrics: Aged accounts receivable (by provider, financial class, and payor)

Report Description: This report shows a detailed breakdown of total aged accounts receivable, for both insurance and self-pay, grouped into aging buckets by billing provider, financial class, or payor level.

Why should I run it? This report shows the age of accounts receivable at a summary and detailed level. This report identifies areas that might need additional review and focused efforts.

Where can I find it? Reporting Workbench in Hyperspace: Epic button > Reports > My Reports > Library > Professional Billing > AR PB Aged Accounts Receivable Report > SCC – Aging AR (ATB)

Note: This report will provide results based on the previous month-end numbers.


What to look for: Use the report to determine what payors/financial classes are taking the longest to respond. Is the long response time normal, or do you need to investigate to see if the payor is receiving and adjudicating these claims?


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PB Daily Payments and Refunds Key Business Metrics: Daily bank deposit

Report Description: This report displays a breakdown of all payments and refunds posted or deposited on a specified date. It is possible to restrict the report to one or more billing providers or leave the billing provider restriction field blank to report on all billing providers within a service area. You can exclude certain payment sources as well.

Why should I run it? This shows end-of-day payment and refund activities and generates a deposit across multiple cash drawers.

Where can I find it? Reporting Workbench in Hyperspace: Epic button > Reports > My Reports > Library > PB Daily Payment and Refund Review > SCC – Daily Payments and Refunds

How often should I run it? Daily (at the end of the day)

What to look for: Use this report to reconcile cash and create daily deposit according to how your practice divides the deposit.


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Follow-Up Workqueue Payor Lag Time Report

Key Business Metrics: Payor lag days

Report Description: This report helps analyze average payor response lag time by workqueue, payor, plan, and reason code organized into 30 day aging buckets. Each line of the report shows how many payor responses during the date range for the report fall into each aging bucket. It also displays what percentage of the total responses on each line is represented by each bucket.

Why should I run it? This report shows how long it takes payors to respond to claims. It is a more detailed view of the Days for Payment section of the Financial Monitoring report previously mentioned.

Where can I find it? In Hyperspace: Epic button > Reports > Professional Billing Reports > Follow-up Workqueue Payor Lag Time Report


What to look for: If there are payors taking unexpectedly long times to make payments, use information from this report and follow up on claims through the insurance follow-up workqueues. Use these tools to address the discrepancies between the time you expected payments to come in and the current aging time.


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Follow-Up Workqueue Summary Report Key Business Metrics: Insurance follow-up (outstanding and denied claims)

Report Description: This report displays all outstanding and denied claims for the practice. The claims are grouped by payor into 30 day aging buckets. The records are divided into Outstanding (Outstd) and Denied columns in the report. The count (Cnt) column refers to the number of follow-up records in the workqueue.

Why should I run it? Use this report to monitor the number of claim records in each workqueue and to plan your focus and activities for the week.

Where can I find it? In Hyperspace: Epic button > Reports > Professional Billing Reports > Follow-up Workqueue Summary Report

How often should I run it? Weekly

What to look for: Rising workqueue volume might mean that your organization is receiving more denials or underpayments, or that payors are responding more slowly to submitted claims. It could also mean that the user assigned to that workqueue is not working records efficiently.

Falling workqueue volume might mean that staff is becoming more efficient at working follow-up records.


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User Activity Summary Key Business Metrics: User productivity

Report Description: Billing office supervisors can use the User Activity Summary to monitor user productivity across workflows. This report provides a daily score based on these points for each user, with details about all of the activities performed that day.

Supervisors can find more detail about a user's daily activities by clicking a hyperlink to open the User Activity Time Log report. They can also export the report data to a spreadsheet for additional analysis and trending.

Why should I run it? Here some common uses for the report:

Monitor Charge Entry Productivity Over the Past Week

• Charge capture supervisors can use the User Activity Summary report to monitor the productivity of their charge entry staff over the past seven days.

Monitor Charge Review Productivity Over the Past Week

• Charge capture supervisors can use the User Activity Summary report to monitor the productivity of their charge review staff over the past seven days.

Monitor Claim Edit Productivity Over the Past Week

• Claim edit supervisors can use the User Activity Summary report to monitor the productivity of their claim edit staff over the past seven days.

Where can I find it? In Hyperspace: Epic button > Reports > Professional Billing Reports > User Activity Summary Report


What to look for: N/A


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Claim Run Info Report Key Business Metrics: Claim run tracking

Report Description: This report provides an overview of the claims contained in an individual claim run. The report is grouped by Payor. It includes summary totals for the number of claims, charges, amount paid, insurance due, patient due and total due. The report also shows information detailing the cross-over transactions included in the run.

Why should I run it? This report monitors the number of claims submitted by your organization broken down by payor within a single batch which allows you to closely monitor the claims being submitted to the clearinghouse or printed internally.

Where can I find it? In Hyperspace: Epic button > Professional Billing > Claims > Claim Run Information


What to look for:

Your claim volume is an important indicator of whether claims are being processed efficiently. Establish an expected volume of claims pre-live to use as a baseline for the volume you see in Epic.

Use this report to monitor what dollar volume and how many claims are being sent to your various payers.


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Claim Run Tracking Report Template Key Business Metrics: Claim run tracking

Report Description: This report details the status of each outstanding claim run, including the number of claims, relative dollar amounts, processed date, and printed date of each claim form. The report is sorted by run number. It includes summary totals for each claim run and service area and a grand total.

Why should I run it? This report monitors the total number of claims submitted by your organization. Compare the Claim Run Tracking report with the report received from the clearinghouse to track all claim runs for a specific time. This helps reconcile what you are generating and what the clearinghouse is receiving.

Where can I find it? Reporting Workbench in Hyperspace: Epic button > Reports > My Reports > Library > Financial > Claim Run Tracking Report


What to look for:

Your claim volume is an important indicator of whether claims are being procesed efficiently. Establish an expected volume of claims pre-live to use as a baseline for the volume you see in Epic.

Use this report in conjuntion with the Claim Edit Workqueue Summary report to monitor how many erred claims are included on each claim run to effectively monitor the volume of your erred claims.


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Claim Edit Workqueue User Productivity Report Key Business Metrics: Claim error summary, user productivity

Report Description: Claims supervisors can run the Claim Edit WQ Productivity report to monitor how effectively claims staff work their errored claims. When a user opens a claim to resolve errors, the system records the errors the user resolves along with any new errors the user introduces.

The report includes summaries of the errors that each user resolved and introduced over the specified date range. Claims supervisors can also choose an interval, so they can review the trend of each user's productivity over several period of time in the Interval Summary section. The Edit Information and Error Code Information sections display the number of times that a user encountered or introduced a particular claim edit or error code, respectively.

Why should I run it? A claims supervisor can review the number and type of errors a user introduces and corrects to determine whether a particular user is inefficient at resolving errors or if she introduces a large amount of errors. The supervisor can also review errors that users have overridden, to determine whether the overrides were appropriate.

Using the information in the Edit Information and Error Code Information sections, supervisors can determine which edits are resolved most often and work to improve registration processes to reduce the number of errored claims. A claims supervisor that wants to determine the most frequent errors can run the Claim Edit Workqueue Summary report (Epic > Reports > Billing Reports > Claim Edit Workqueue Report).

Where can I find it? Reporting Workbench in Hyperspace: Epic button > Reports > My Reports > Library > Claim Edit Workqueue Productivity > Claim Edit Workqueue Productivity


What to look for: Use the information on claim edits to identify areas where the organization can make improvements that get claims out the door more efficiently.

Identify the most frequently violated errors, as well as errors holding up the largest amount of money, on a regular basis to pin-point specific areas where training could be emphasized as well as other issues the errors might cause.

Identify the users who are the most productive at resolving claim edits in your system.

https://documentation.epic.com/Redirect.aspx?DocumentID=1013974&Version=Epic%202012

https://documentation.epic.com/Redirect.aspx?DocumentID=1013974&Version=Epic%202012


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Cash Drawer Closing Detail Report Key Business Metrics: Monitor cash reconciliation at end of day

Report Description: The Epic cash drawer is a virtual equivalent to the physical cash drawer that holds dollar bills, checks, and credit card receipts. The virtual cash drawer tracks all payments collected during any workflow in the system by a user or a specific computer terminal. The expectation is that this helps reconcile what is in the physical cash drawer. Print the Enterprise Cash Drawer Closing report by selecting the Print report when drawer is closed check box. The Enterprise Cash Drawer Closing report offers a high-level view of the contents of an envelope, a list of payments that were removed from the drawer, and information related to any voids that were recorded to the drawer.

When a supervisor runs the Enterprise Cash Drawer Closing Detail in Reporting Workbench, she can specify whether she wants to see unbalanced drawers, specific users’ cash drawers, and/or look at users who are under a specific supervisor. This report details the cash drawer user, the date/time the cash drawer was closed, along with payment amounts posted, the account each payment was posted to, and the difference in closing amount to what was posted in the system.

Why should I run it? This report shows the detail of each user’s cash drawer and should be used to monitor users’ cash reconciliation and identify unbalanced cash drawers.

Where can I find it? Reporting Workbench in Hyperspace: Epic button > Reports > My Reports > Library > Financial > Enterprise Cash Drawer Closing Detail

How often should I run it? Daily (after cash drawers have been closed)

What to look for: Follow-up with users who have unbalanced cash drawers in order to increase cash reconciliation at end of day.


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Encounter Form Control Report Key Business Metrics: Missing charges for scheduled visits

Report Description: This report determines whether any patients have been checked in but have not had charges posted to their accounts. Run this report by encounter form number or encounter date and sort by provider.

Why should I run it? If the report reveals that charges are missing, you know which patients for which charges are missing and can clean up accounts before doing end-of-day balancing.

Where can I find it? In Hyperspace: Epic button > Reports > Professional Billing Reports > Encounter Form Control Report


What to look for:

• When charges are posted to the account for an encounter the amount appears in the Charges column. If charges are pending for the encounter, the amount and the workqueue ID for the charge session appears. When charges are missing, the Charges column displays only the appointment status. Limit the report to show only encounters without charges posted and address those encounters during end-of-day processes.

• If an encounter is missing charges, it might be: • The clinician has not closed the encounter in EpicCare Ambulatory. Charges only file when the

encounter is closed. • The charges have not been entered into the system by charge entry staff. • The charges are in the system, but are not associated with an encounter number. In this case, the

system does not recognize that charges have been filed for that particular encounter. • If the patient has arrived but has no charges pending or filed to the accounts, follow-up with physicians

and/or staff.


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All User Batch Report Key Business Metrics: End users’ system activity

Report Description: This report totals all of the charges, payments, and adjustments that each user posted in a day, as well as the totals for all users.

Why should I run it? Run this report at the end of the day to ensure that all cash and all encounter forms are accounted. This report should is part of the end-of-day balancing routine.

Where can I find it? Reporting Workbench in Hyperspace: Epic button > Reports > My Reports > Library > PB All User Batches > SCC – PB All User Batch Report


What to look for: Compare user productivity levels to identify more productive users versus less productive users in terms of entering charges, payments, and adjustments.


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Generic Transaction Search Key Business Metrics: N/A

Report Description: This flexible report allows for searching on user-specified criteria restrictions.

Why should I run it? Search on specific criteria to research transactions based on that criteria. It should not be used as a replacement for monthly reporting through Clarity or for searches returning large amounts of data.

Where can I find it? Reporting Workbench in Hyperspace: Epic button > Reports > My Reports > Library > Professional Billing > PB Generic Transaction Search > PB Generic Transaction Search

How often should I run it? Ad hoc

What to look for: N/A – varies by search criteria

** Also search SCC – Monthly or SCC – Daily for summarized information for Charges, Payments, or Adjustments


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Guarantor Account Search Report Key Business Metrics: Self-pay follow up

Report Description: This report allows your organization to monitor guarantors’ accounts and view accounts based on specified criteria, such as accounts that are outstanding. You have the option to jump into account contact and perform follow-up activities from the report.

Why should I run it? Run this report to follow-up on guarantor accounts based on your account follow-up practices.

Where can I find it? Reporting Workbench in Hyperspace: Reports > My Reports > Library > Professional Billing > Guarantor Account Search > SCC - Guarantor Account Search

How often should I run it? According to your organization’s follow-up practices

What to look for: Use this report as a work list to monitor your office’s guarantor account balances and perform follow-up on accounts.


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Daily Production Summary Report Key Business Metrics: Daily charges, payments, debit adjustments, credit adjustments, total change in AR

Report Description: This report summarizes all of a system batch's charge activity. It reports on transactions posted on a specified date and summarizes the total charges, payments, and adjustments posted on that day.

Why should I run it? Run this report to monitor daily changes in revenue and charge, payment, and adjustment activity at a higher level.

Where can I find it? Reporting Workbench in Hyperspace: Epic button > Reports > My Reports >Library > Professional Billing > PB Daily Production Summary > PB Daily Production Summary


What to look for: Use this report to monitor your office’s daily activities and as a tool when working with your accountant for daily balancing.


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Billing Procedures by Provider Report Description: This report provides a summary count by billing provider and then procedure charged by providers in your department. The parameters are start Post Date/Service Date, Service Area, Department of Service, Revenue Location and Procedure.

Why should I run it? This report helps monitor providers’ monthly reimbursement for specified procedures by payors.

Where can I find it? Reporting Workbench in Hyperspace: Epic button >Reports >My Reports > Library > SCC - Procedures by Billing Provider



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Cadence/Prelude Reports


My Patients List .......................................................................................................... 44

Canceled Appointments by Dept, Provider, and Cancel Reason ................................. 45

Appointment Statistics by Department ........................................................................ 46

Follow-up Work List Report ......................................................................................... 47

Payor Mix .................................................................................................................... 48


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My Patients List Key Business Metrics: Patients seen at the practice

Report Description: This is a generic patient list report that can be configured to simply show all patients seen at the practice or even patients with a specific diagnosis. Some of the columns include are basic demographics, PCP, email address, as well as primary and secondary coverages

Why should I run it? To view patients seen at the practice for tracking or outreach

Where can I find it? Reporting Workbench in Hyperspace: Epic button > Reports > My Reports > Library > SCC – My Patients List

How often should I run it? Quarterly



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Canceled Appointments by Dept, Provider, and Cancel Reason Key Business Metrics: Canceled appointments statistics

Report Description: This report displays a summary of canceled appointments that were scheduled for a specific date range. The report is grouped and sorted by department, provider, and cancel reason.

Note: If you use joint appointment functionality in Cadence, this report only shows the appointment cancellation information by the first provider listed on a joint appointment.

Why should I run it? It provides an overview of the number of appointments canceled, by provider, and the reason for cancellation.

Where can I find it? Reporting Workbench in Hyperspace: Epic button > Reports > My Reports > Library > Appointment Stats by Dept > SCC - Canceled Appointments by Department

How often should I run it? Quarterly

What to look for: This report provides the number of canceled appointments over the last quarter, along with reasons for cancellation, by provider. You can determine if the appointment was canceled by the patient or the provider.


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Appointment Statistics by Department Key Business Metrics: Appointment statistics, including arrived, canceled, completed, no show, and scheduled appointments

Report Description: This report shows the appointments with their appointment status, appointment type, cancellation reason, and confirmation status.

Why should I run it? It provides a review of total appointments and the number of appointments that have been scheduled versus completed, canceled, or no-showed.

Where can I find it? Reporting Workbench in Hyperspace: Epic button > Reports > My Reports > Library > SCC - Appointment Statistics by Department


What to look for: This report helps identify the average number of scheduled, canceled, completed, and no-show appointments on a monthly basis.


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Follow-up Work List Report Key Business Metrics: Re-schedule work list

Report Description: Schedulers and front desk staff can use the Follow-up work list to resolve past appointments that were canceled or for which patients failed to present.

Why should I run it? The work list displays the status of incomplete appointments, how many calls have been made to the patient about the appointment, and the appointment cancellation reason (only if the appointment was canceled). Using this information, schedulers and front desk staff can reschedule appointments or remove them from the work list as needed.

Note that the Follow-up work list is used for no-show appointments and patient-initiated cancellations.

Where can I find it? Reporting Workbench in Hyperspace: Epic button > Scheduling > Work Lists > Follow-up

How often should I run it? Weekly/Monthly

What to look for: This report includes incomplete appointments that meet specific criteria, such as appointments in a specific department or with a certain status. For this report, incomplete appointments are defined as any appointments that were not considered complete when end-of-day (EOD) processing ran for the day of the appointments, as well as any appointments that have not yet gone through EOD processing, but would be considered incomplete when they do.

For each appointment on the report, you can see information about the appointment, like the appointment date, time, status, patient name, visit type, appointment provider, and number of calls.


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Payor Mix Key Business Metrics: Count and percentage of patients seen by payor

Report Description: This report displays the breakdown of patients seen by carrier. Three views are included by default: Pie – Pt Percentage by Payor, Pie – Pt Count by Payor, Table – Pt Count by Payor

Why should I run it? If provides a visual representation of you patients grouped by payor

Where can I find it? Reporting Workbench in Hyperspace: Epic button > Reports > My Reports > Library >SCC – Payor Mix

How often should I run it? Quarterly/Annually

What to look for: Practice managers may way to consider utilizing this report to aid in deciding whether to continue accepting certain payors that very few patients have.


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Ambulatory Reports


EpicCare Ambulatory Reports – Administrative........................................................... 52

Open or Closed Encounters List ................................................................................. 52

EpicCare Ambulatory – Patient Care .......................................................................... 53

Find Orders ................................................................................................................. 54

Health Maintenance Due............................................................................................. 55

My Patients w/ X Diagnosis ......................................................................................... 56

My Patients Currently Taking X ................................................................................... 57


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EpicCare Ambulatory Reports – Administrative The following reports are for the office manager to run on a monthly basis. These reports display useful information on providers’ ordering and diagnosing tendencies to help the office manager identify trends. Report results ensure providers are seeing an appropriate number of patients each day and are closing their encounters in a timely fashion. Open or Closed Encounters List Report Description: This report displays the number of closed and open encounters by provider in a specific department within a specific time.

Why should I run it? This report provides a breakdown, per provider or department, on the number of patient encounters that are currently open. Use this report to determine if providers are becoming more efficient with the system. The number of closed encounters on the day the patient was seen should increase. This report also identifies providers that might need additional training to become an efficient user.

Where can I find it? Reporting Workbench in Hyperspace: Epic button > My Reports > Library >SCC - Open Encounters List or SCC – Closed Encounters List



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EpicCare Ambulatory – Patient Care

The following reports are for a physician to run when she wants information on topics such as chronic disease management, preventive care, and other patient data. The reports display different columns so that the most relevant information is available within each report. For example, the My Diabetic Patients report displays the patient’s last HDL and A1C, while the My Patients on Digoxin report does not display these results because they are not as clinically relevant for such a report. Because there are so many variations of these reports, this document only describes a few. The table following the examples provides you with a comprehensive list of the reports available.


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Find Orders Report Description: This report can locate orderables placed for a date range. Labs, medications, and imaging can all be reported on as well as the current status in the system.

Why should I run it? Practice managers can utilize this report to see orders placed by provider to check on productivity within their organization.

Where can I find it? Reporting Workbench in Hyperspace: Epic button > Reports > My Reports > Library > SCC – Find Orders

How often should I run it? Ad‐hoc


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Health Maintenance Due Report Description: This report can locate patients seen in the time frame with a Health Maintenance Topic that is due. The status can also be changed depending on the goals of the report.

Why should I run it? Practice managers can utilize this report for outreach to patients with upcoming immunizations or exams that have not been scheduled.

Where can I find it? Reporting Workbench in Hyperspace: Epic button > Reports > My Reports > Library > SCC – Health Maintenance Due or Due Soon.

How often should I run it? Ad‐hoc


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My Patients w/ X Diagnosis Report Description: This report displays all of your patients (if you are the encounter provider or PCP) who have been diagnosed with a specific diagnosis.

Why should I run it? You can identify all of your patients with specific diseases and perform a number of actions from this report, like add patients to a patient list, generate letters, or initiate telephone encounters.

Where can I find it? Reporting Workbench in Hyperspace: Epic button > Reports > My Reports > Library > Ambulatory > AMB ADVANCED FIND PATIENTS > SCC – Find Patients w/ X Diagnosis

How often should I run it? Ad-hoc


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My Patients Currently Taking X Report Description: This report displays all of your patients (if you are the encounter provider or PCP) who are currently taking a specific medication.

Why should I run it? You can identify all of your patients taking specific medications and perform a number of actions from this report, like add patients to a patient list, generate letters, or initiate refill encounters.

Where can I find it? Reporting Workbench in Hyperspace: Epic button > Reports > My Reports > Library > Ambulatory > AMB ADVANCED FIND PATIENTS > SCC – Find Patients Currently Taking X

How often should I run it? Ad-hoc


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BI Launch Pad Reports


BI Launch Pad Reports *PB Clients Only* .................................................................. 60

Cadence/Prelude ........................................................................................................ 61

Ambulatory .................................................................................................................. 63

Billing/Revenue ........................................................................................................... 65


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BI Launch Pad Reports *PB Clients Only* Although BI Launch Pad reports are run based on data that is gathered by Epic, the reports themselves are not actually run from within Epic. In order to maintain the integrity and isolation of your practice’s financial and scheduling data, end-users do not have access to run these reports.

If you find that a BI Launch Pad report would be beneficial to you and your practice, initiate a conversation with your Account Manager outlining what report(s) you would like. These reports can then be generated, either once, (ad hoc to meet a specific need), or on a set schedule, and distributed to you electronically.


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Cadence/Prelude

Appointment Statistics by Department Key Business Metrics: Appointment statistics volume totals, including arrived, canceled, completed, no show, and scheduled appointments

Report Description: This report provides a summary of appointment statuses with month‐to‐date and year‐to‐date totals.

Why should I run it? It provides a high‐level review of total appointments, the number of appointments that have been scheduled versus completed, canceled, or no‐showed.


What to look for: This report helps identify the average number of scheduled, canceled, completed, and no‐show appointments on a monthly basis.


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Slot Utilization by Provider Key Business Metrics: Schedule utilization

Report Description: This report shows how much of a provider's schedule was used during a specified time range and groups the data by the provider's departments. It displays how much of the provider's schedule was full, as well as how many overbooks/overrides/unavailable slots were scheduled. This report can be used to ensure that scheduled sessions are being fully used. Additionally, this report helps project increases in appointment volumes.

Why should I run it? It provides an overview of the number of unused slots in a provider’s schedule over a specified time range, along with statistics on blocks and unavailable time.


What to look for: This report provides an overview of the number of unused appointment times per provider, along with statistics of blocked and unavailable slots. Use this information to predict schedule availability for the next time period.


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Ambulatory Procedure Utilization Key Business Metrics: Procedure count, unit count, charges, patient payment, insurance payment, contractual adjustment, and outstanding amount. Can be grouped by revenue location, department, place of service, billing provider, performing provider, original financial class, and original payor

Report Description: The Procedure Utilization with Flexible Grouping report allows you to see which procedure codes were billed out between the service dates entered and includes a procedure count as well as unit count. It will include any matched payment (separated columns for Patient and Insurance payment totals), contractual, bad debt, and “other” adjustments.

Why should I run it? This will allow the practice to view usage of various procedure codes

How often should I run it? Month end



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Top X Diagnoses by Department Key Business Metrics: Code set, diagnosis code, diagnosis name, rank, number of patients

Report Description: The Top X Diagnoses by Department report will allow user to view the top diagnoses associated with visits within a set time frame.

Why should I run it? Practices can use this for decision making and performance evaluation

How often should I run it? N/A



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Billing/Revenue

Currently there are three reports that are automatically delivered for every SCC practice utilizing the PB module, after month-end. If no specific grouping is requested by the practice, then the standard grouping is provided.

Charges, Payments & Adjustments—grouped by Current Financial Class then Curent Payor.

This report shows the previous month’s totals for: Quantity, Charges, Payments, Debit Adjustments, Credit Adjustments and the Net change for each Financial Class and Servicing Provider.

Aged Trial Balances—grouped by Current Financial Class then Curent Payor

This report shows your Accounts Receivable (AR) aged out by days in the following aging buckets: 0-30, 31-60, 61-90, 91-120, 121-150, 151-180, 181-270, 271-360 and Greater than 360 as well as a Total balance for each Payor and Financial Class. This report is useful to determine which payor(s) have the largest outstanding balance.

Days in AR—grouped by Original Financial Class and then Original Payor

This report shows the previous month’s totals for: Charges, Ending Accounts Receivable (AR), Average Charges Per Day and Average Days in AR from each Payor and Financial Class. This report is useful to determine how quickly payments are collected from various payors .

Understanding “No Provider” listing on BI Launch Pad Reports:

When transactions are listed under “No Service Provider”, they are transactions from the practice that have become undistributed. These amounts could be a result of such transactions as, refunds, prepayments, and co-payments. Since these payments are no longer distributed to a charge or specific provider, they are held in another bucket and will appear under “No Service Provider” until they are re-distributed.


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Charges, Payments, Adjustments Key Business Metrics: Quantity, Charges, Payments, Debit Adjustments, Credit Adjustments and Net change.

Report Description: This report provides a summary, (optionally grouped in different ways), of charges, payments and adjustments over the selected date‐range. The report shows financial activity based on user-selected groupings.

Why should I run it? CFOs and billing office managers can use the Charges, Payments, Adjustments with Flexible Grouping MTD or YTD report to track the state of the billing program at a very high level.


What to look for: Managers can use month‐to‐date and year‐to‐date information to identify trends and anomalies across and within service areas


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Aged Trial Balance Key Business Metrics: Beginning AR Balance, 0-30, 31-60, 61-90, 91-120, 121-150, 151-180 and 181+ aging bucket balances.

Report Description: The report shows AR divided into seven aging buckets based on the post date of the transactions. You can choose to group the report by up to three levels ‐ including service area, financial class, payor, plan, department, provider, and account, among others.

Why should I run it? Billing office managers and financial executives can use the Aged Trial Balance report to review aged AR by a number of groupings and pinpoint areas that might need additional attention.


What to look for: Use this report to identify payors that respond less promptly and target them for more aggressive follow‐up and contract negotiations. Or, spot departments or locations that might need additional training or resources for insurance and self‐pay follow‐up.


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Charges and Days in AR Report Key Business Metrics: Charges, Ending AR, Average Charges per Day and Days in AR Report Description: This report provides a summary, (optionally grouped in different ways), of outstanding AR and shows the number of Days in AR—the number of days it takes, on average, to be paid.

Why should I run it? Billing office managers can use the Charges and Days in AR report to monitor AR turnover at a variety of levels. This report can include up to three levels of grouping.


What to look for: Use this report to pinpoint particular areas, such as departments or payors that have higher than average AR days. They can then target these areas for more aggressive analysis and follow-up, which can bring down your organization's AR days overall.


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Financial Activity Report Key Business Metrics: Charges, payments, debit adjustments, credit adjustments and net change in AR grouped by: billing provider, current financial class, current payor, current plan, current product type, department, department specialty, location, original financial class, original payor, original plan, original product type, place of service, POS type, procedure category, procedure code, service area or service provider. Report Description: The PB Financial Activity with Flexible Grouping report helps you monitor financial activity (transactions posted, voided, reversed, and matched) for a specified date range, sorted and totaled by groups you define. Charges (including charges posted and/or voided in the specified period), Payments (including payments posted, voided, reversed, distributed and/or undistributed), Debit Adjustments (including debit adjustments posted and/or voided in the specified period), Credit Adjustments (including credit adjustments posted, voided, reversed, distributed and/or undistributed), and Net Activity appear in the report.

Why should I run it? This report provides a detailed provider‐level view of how successfully charges are captured and paid by the patient and insurance carriers. This level of detail is essential at month end for tracking and reconciling financial reports.

How often should I run it? Month end What to look for: Based on pre‐live levels, determine for charges, payments, and adjustments on a monthly basis. Use the report to compare pre‐live metrics to post‐live metrics and monitor your volumes per provider.


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Charge Audit Detail Key Business Metrics: Original plan, original payor, current plan, current payor, service provider, billing provider, referring provider, department name, POS name, POS code, revenue location, patient MRN, patient name, birth date, age, service date, charge post date, void date, procedure code, billing cpt code, procedure code description, charge modifier, units, diagnosis code 1-6, diagnosis description 1-6, charge amount, contractual adjustment amount, total payment amount, insurance payments, patient payments, and outstanding amount. Report Description: The Charge Audit Detail report is a large report that shows by charge line item, various pieces of information including clinical and billing related data. This report is primarily used as an analytical report ran MTD or YTD.

Why should I run it? For users that want to data mine may find this report useful for their practice. The report is raw and contains no special formatting, so the use of pivot tables to summarize data in a meaningful way is recommended.

How often should I run it? Month end


Documents

Reference Guide - Sutter Community Connect