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At a Glance

The Revenue Analysis page in Insights allows you to view overall figures and trends in your practice’s collections, as well as the ability to filter results down to individual dates, payers, facilities, or providers. When you know exactly how much revenue is generated over specific time periods from either aggregate or individual providers, payers, and even CPT codes, you can optimize your practice’s resources, spot red flags more quickly, and improve the overall financial health of your organization.

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Features of the Page

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By the Numbers

At the top of the Revenue Analysis page, you will see these four tiles. By default, they will be filtered to show results from the previous 31 days, though you can adjust the date range by clicking on the calendar icon.
  • Total PaymentsThis number shows the sum of all payments from payers and patients for the given date range. You can see how it compares both in percentage and real dollars to the previous period.
  • Median Time to DecisionThis number shows the average number of days from date of service to payer decision for a given time period. You can how that time lapse compares to that of the previous period.
  • Insurance Paid RateThe higher the better. This number shows the percentage of claims successfully paid, as well as how that number compares with the previous period.
  • $ Paid Per EncounterThe average dollar amount paid to your practice per patient encounter. Each section that follows has a ‘Download CSV’ button in the top right corner. Use this if you would like to analyze the raw data in Excel, Google Sheets, or some similar spreadsheet.

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Monthly Revenue

This bar chart shows the combined amounts paid by insurers and patients each month. It will default to show results by date posted, though you can also show results by Check Date or Date of Service, as shown below. The benefit of showing results by Date of Service is that you can see how the total paid compares with the total projected amount your practice should be paid. Along with Insurance Paid and Patient Paid, these bars also show the total amount pending from patients as well as payers. If, for example, you notice that the gap between actual dollars paid and projections are steadily widening month to month, you can use that information to find the root cause. This may involve improving PR collection strategies at the front desk, or contacting payers that have fallen behind on reconciliations.

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Payments by Segment

The Payments by Segment tool allows you to analyze how much total revenue is generated over a period of time by individual payers, facilities, insurance providers, CPT codes, line items, and users. Having these kinds of real-time metrics at your fingertips allows you to pinpoint, for example, which providers or new CPT codes are either underperforming or doing particularly well, so that you can highlight effective practices to your team and focus assistance where it is needed most.

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Patient Responsibility

This shows the total PR collected over a given time period, divided into three categories:
  • Smart PayPayments made through patient payment portals, those made through saved cards, and those made via digital reminders are all considered Smart Pay.
  • Stripe Card ReaderPayments collected through your Athelas card reader.
  • ExternalAny cash, check, or other kinds of payments will be recorded here. Keep an eye on any unexpected dips in PR collection. This can signal a need for some greater effort to collect outstanding PR.

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Front Desk Collections

Ideally, all PR would be collected at the front desk on the date of service, though it is common knowledge that this is not a realistic expectation. The Front Desk Collections section provides both the total percentage of PR collected and uncollected, as well as filters to show how specific facilities, providers, and users are performing. Again, you can use this information to highlight effective practices to your team and troubleshoot underperformance.

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Claims Waterfall

The claims waterfall section details how many encounters turn into paid claims at your practice, and the amount of attrition at each step of that process. From left to right, for each adjustable time period, you can see:
  • The total number of encounters
  • The number of claim submissions resulting from those encounters
  • How many of those claim submissions passed all technical checks by our clearinghouse
  • The number of claims reconciled, and finally
  • How many were paid in full. Using this graph can show you which stage of the process results in the greatest claims drop-off, empowering you to zero in on root issues more quickly.

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Reconciliation Speed

This chart specifically shows payers’ submitted claims versus reconciled claims. This can be a great indicator of red flags when analyzed. In this example, we can see that while 96 claims were submitted to UB-Anthem Blue Cross California, only 14 have been reconciled in the given date range. Discrepancies like this would warrant a closer look—it would be wise to ensure that the rules engine is working properly for these claims, for example.

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First Pass Rate

Achieving and maintaining a high first pass rate is the gold standard at Athelas. Claims that are submitted and approved in one fell swoop are indicators that our rules engine is working properly, claims are submitted on time, and everyone is happy. If you notice your first pass rate dips significantly, talk to your account manager and we’ll see what’s going on with the rules engine.

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Insurance Paid Rate

Last but not least, this chart shows the percentage of claims with an insurance payout. Watching for dips in percentage here can alert you to some new rule or protocol by a payer that we need to address in the rules engine, for example.

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We also provide General Support on:

Features Supported
  • Ingestion of old biller’s data to set insurance collections benchmarks
  • Internal tracking that flags customers that are below expected benchmarks and presentation of findings to customers
  • Quarterly Business Reviews for customers worth $150,000 monthly; Biannual Business Reviews for all other customers Features In Development
  • Visibility of all Quarterly/Biannual Business Review metrics in Insights
  • Cohort analysis with customers of similar size, and in similar regions and industries
  • Best practice recommendations for revenue optimization based on cohort analysis

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Further Assistance

We’re here to help! Please get in touch with [email protected] if you’d like some hands-on assistance.