Billing Analytics

The Billing Analytics package in iSalus allows user to develop custom reports based on fields and measures in the below data dictionary. The data is refreshed nightly at 4am EST. A New Billing Analytics package has been created with usability improvements to the original billing analytics package. 

Once your practice has been set up to utilize this feature, you can launch Billing Analytics by following these steps:

1.  Navigate to Reports
2.  Click Billing Analytics
3.  A pop up will appear prompting you to save the report – Save the ‘iCube’ file in a location that you plan on saving the report.
4. Once you save the report, Microsoft Excel will open for you automatically with the Pivot Fields displayed on the right hand side.

Facts

In Microsoft Excel, ‘Facts’ are the actual numbers that you are able to analyze/report on.  This type of data is quantitative (numbers).

• Fact Claim Charges: This data is derived from the charges (aka Procedures) on a claim.   
  • Charge Amount: The included charge dollar amount(s).
  • Charge Default RVU: RVUs as set in the Procedure for the currently included charges; will be totaled across all charges unless/until broken out by Procedure Code.
  • Charge Total RVU: Charge units x Default RVUs (as set in the Procedure) for the currently included charges.
  • Charge Unit Amount: Total Charge Units x Charge Amount for the currently included charges.
  • Charge Units: The total charge units across all included claims.
  • Claim Count: The total claims making up the included charges.
  • Procedure Count: The number of unique procedures used across all included claims.
• Fact Claim Payments: This data is derived from payments that are posted against procedures.   Keep in mind, both Payments and Adjustments are categorized as ‘Payments’.  So, it is often helpful to use a dimension (described below) to separate out Payments and Adjustments. 
  • Claim Count with Payments: The total included claims which have payments recorded.
  • Payment Amount: The included payment dollar amount(s).
  • Payments Count: The count of all included payments.

Dimensions

In Microsoft Excel, ‘Dimensions’ are how you might analyze or break down a number.  This type of data is qualitative (categories).

• Claim Level: The current billing level (primary, secondary, tertiary, etc.) of the included claims.
  • Dim Level Type: The different billing levels, categorized by an iSalus internal unique identifier.
  • Level Type Code: The different billing levels, categorized by code.
    • 1 = Primary, 2 = Secondary, 3 = Tertiary, C = Completed, S = Statement, U = Unassigned
  • Level Type Description: The different billing levels by description.
  • Update Date: The last date the description of the Claim Level was modified within the database.
• Claim Owner: The current user assigned as Owner on the included claim(s).
  • Dim User: Users who are assigned as owner(s) on the included claim(s), categorized by an iSalus internal unique identifier.
  • Update Date: The last date the user information tied to the owner was modified within the database.
  • User Code: The user ID of the owner(s) assigned to the included claim(s).
  • User Name: The full user name of the owner(s) assigned to the included claim(s).
• Claim Primary Carrier: The current primary insurance carrier on the included claim(s).
  • Carrier Claim Filing Type: The Source of Pay (as chosen in Payer Setup) for the primary carrier on the included claim(s).
  • Carrier EDI: The clearinghouse (as chosen in Payer Setup) for the primary carrier on the included claim(s).
  • Carrier Financial Class: The Financial Class assigned to each payer (within Payer Setup) for the primary carrier on the included claim(s). 
  • Carrier Name: The descriptive payer name (as entered in Payer Setup) for the primary carrier on the included claim(s).
  • Carrier Payer ID: The claim submission payer ID (as entered in Payer Setup) for the primary carrier on the included claim(s).
  • Dim Primary Carrier: The primary carrier on the included claim(s), categorized by an iSalus internal unique identifier.
  • Update Date: The last date the description of the Primary Carrier was modified within the database.
• Claim Primary Diagnosis: The current diagnosis code in the first (primary) diagnosis field on the included claim(s).
  • Diagnosis Code: The ICD alphanumeric code on the included claim(s).
  • Diagnosis Code Description: Both the ICD alphanumeric code and the text description on the included claim(s).
  • Diagnosis Description: The text description for the primary ICD code on the included claim(s).
  • Dim Primary Diagnosis: The primary diagnosis on the included claim(s), categorized by an iSalus internal unique identifier.
  • Update Date: The last date the description of the ICD alphanumeric was modified within the database.
• Claim Status: The current Claim Status on the included claim(s).
  • Claim Status Description: The text description for the current Claim Status on the included claim(s).
  • Dim Claim Status: The current Claim Status on the included claim(s), categorized by an iSalus internal unique identifier.
  • Update Date: The last date the description of the Claim Status was modified within the database.
• Claim Submission Type: The current Submission (Billing) Type (Electronic vs. Paper) on the included claim(s).
  • Billing Type Code: The current Submission (Billing Type) on the included claim(s), by code.
    • E = Electronic, P = Paper
  • Billing Type Description: The text description of the current Submission (Billing Type) on the included claim(s). 
  • Dim Billing Type: The current Submission (Billing) Type on the included claim(s), categorized by an iSalus internal unique identifier.
  • Update Date: The last date the description of the Claim Submission (Billing) Type was modified within the database.
• Claim Substatus: The current Claim Substatus on the included claim(s).
  • Claim Sub Status Description: The text description for the current Claim Substatus on the included claim(s).
  • Dim Claim Substatus: The current Claim Substatus on the included claim(s), categorized by an iSalus internal unique identifier.
  • Update Date: The last date the description of the Claim Substatus was modified within the database.
• Claim Type: The current Claim Type (Medical, Dental, EPSDT, DME, etc.) on the included claim(s). NOTE: Medical is the default Claim Type on all claims.
  • Claim Type Code: The current Claim Type on the included claim(s), by code.
    • F = Medical
  • Claim Type Description: The text description of the current Claim Type on the included claim(s). 
  • Dim Claim Type: The current Claim Type on the included claim(s), categorized by an iSalus internal unique identifier.
  • Update Date: The last date the description of the Claim Type was modified within the database.
• Client: The current Client Database information on the included claim(s).
  • Client Alias: The client database assigned alias, associated with the included claim(s), which may be used to log into the database in the Company field on the login page.
  • Client Key: The client database auto assigned (when a new database is generated) key associated with the included claim(s).
  • Client Name: The client database auto assigned Company Name, associated with the included claim(s), which may be used to log into the database in the Company field on the login page.
  • Dim Client: The iSalus internal unique identifier for the client database associated with the included claim(s).
  • Update Date: The last date the assigned Company Name was modified within the database.
• Date Claim Charge Analytic: The claim charge data date(s) as of the last time the data analytics was updated. iSalus does not recommend using this date.
  • Date Claim Charge Analytic.Year Value – Quarter Value – Year Month – Date Value: Selecting this value will break out the included claim charge(s) starting by Year; example:
    • 2018 -> Q1 -> January, February, March -> 2018-01-01, 2018-01-02, 2018-01-03, etc.
  • Date Claim Charge Analytic.Date Value: Selecting this value will break out the included claim charge(s) by calendar date, regardless of year.
  • Date Claim Charge Analytic.DateID: The iSalus unique identifier for the Claim Charge Analytic calendar date.
  • Date Claim Charge Analytic.Quarter Value: Selecting this value will break out the included claim charge(s) by Quarter, regardless of year.
  • Date Claim Charge Analytic.Year Month: Selecting this value will break out the included claim charge(s) by calendar month, regardless of year.
  • Date Claim Charge Analytic.Year Value: Selecting this value will break out the included claim charge(s) by year, with no additional breakdown.
• Date Claim Charge Post: The claim charge data date(s) based on when the charges were posted/entered. This field can not be changed by users.
  • Date Claim Charge Post.Year Value – Quarter Value – Year Month – Date Value: Selecting this value will break out the included claim charge(s) starting by Year; example:
    • 2018 -> Q1 -> January, February, March -> 2018-01-01, 2018-01-02, 2018-01-03, etc.
  • Date Claim Charge Post.Date Value: Selecting this value will break out the included claim charge(s) by calendar date, regardless of year.
  • Date Claim Charge Post.DateID: The iSalus unique identifier for the Claim Charge Post calendar date.
  • Date Claim Charge Post.Quarter Value: Selecting this value will break out the included claim charge(s) by Quarter, regardless of year.
  • Date Claim Charge Post.Year Month: Selecting this value will break out the included claim charge(s) by calendar month, regardless of year.
  • Date Claim Charge Post.Year Value: Selecting this value will break out the included claim charge(s) by year, with no additional breakdown.
• Date Claim Charge Service: The claim charge data date(s) as of the Charge Date of Service.   This field can be changed by users.
  • Date Claim Charge Service.Year Value – Quarter Value – Year Month – Date Value: Selecting this value will break out the included claim charge(s) starting by Year; example:
    • 2018 -> Q1 -> January, February, March -> 2018-01-01, 2018-01-02, 2018-01-03, etc.
  • Date Claim Charge Service.Date Value: Selecting this value will break out the included claim charge(s) by calendar date, regardless of year.
  • Date Claim Charge Service.DateID: The iSalus unique identifier for the Claim Charge Service calendar date.
  • Date Claim Charge Service.Quarter Value: Selecting this value will break out the included claim charge(s) by Quarter, regardless of year.
  • Date Claim Charge Service.Year Month: Selecting this value will break out the included claim charge(s) by calendar month, regardless of year.
  • Date Claim Charge Service.Year Value: Selecting this value will break out the included claim charge(s) by year, with no additional breakdown.
• Date Claim Payment Analytic: The claim Payment data date(s) as of the last time the data analytics was updated. iSalus does not recommend using this date.
  • Date Claim Payment Analytic.Year Value – Quarter Value – Year Month – Date Value: Selecting this value will break out the included claim payment(s) starting by Year; example:
    • 2018 -> Q1 -> January, February, March -> 2018-01-01, 2018-01-02, 2018-01-03, etc.
  • Date Claim Payment Analytic.Date Value: Selecting this value will break out the included claim payment(s) by calendar date, regardless of year.
  • Date Claim Payment Analytic.DateID: The iSalus unique identifier for the Claim Payment Analytic calendar date.
  • Date Claim Payment Analytic.Quarter Value: Selecting this value will break out the included claim payment(s) by Quarter, regardless of year.
  • Date Claim Payment Analytic.Year Month: Selecting this value will break out the included claim payment(s) by calendar month, regardless of year.
  • Date Claim Payment Analytic.Year Value: Selecting this value will break out the included claim payment(s) by year, with no additional breakdown.
• Date Claim Payment Deposit: The claim Payment data date(s) based on Payment Deposit Date.   This field can be changed by users.
  • Date Claim Payment Deposit.Year Value – Quarter Value – Year Month – Date Value: Selecting this value will break out the included claim payment(s) starting by Year; example:
    • 2018 -> Q1 -> January, February, March -> 2018-01-01, 2018-01-02, 2018-01-03, etc.
  • Date Claim Payment Deposit.Date Value: Selecting this value will break out the included claim payment(s) by calendar date, regardless of year.
  • Date Claim Payment Deposit.DateID: The iSalus unique identifier for the Claim Payment Deposit calendar date
  • Date Claim Payment Deposit.Quarter Value: Selecting this value will break out the included claim payment(s) by Quarter, regardless of year.
  • Date Claim Payment Deposit.Year Month: Selecting this value will break out the included claim payment(s) by calendar month, regardless of year.
  • Date Claim Payment Deposit.Year Value: Selecting this value will break out the included claim payment(s) by year, with no additional breakdown.
• Date Claim Payment Post: The claim Payment data date(s) based on Payment Post Date. This field can not be changed by users.
  • Date Claim Payment Post.Year Value – Quarter Value – Year Month – Date Value: Selecting this value will break out the included claim payment(s) starting by Year; example:
    • 2018 -> Q1 -> January, February, March -> 2018-01-01, 2018-01-02, 2018-01-03, etc.
  • Date Claim Payment Post.Date Value: Selecting this value will break out the included claim payment(s) by calendar date, regardless of year.
  • Date Claim Payment Post.DateID: The iSalus unique identifier for the Claim Payment Post calendar date
  • Date Claim Payment Post.Quarter Value: Selecting this value will break out the included claim payment(s) by Quarter, regardless of year.
  • Date Claim Payment Post.Year Month: Selecting this value will break out the included claim payment(s) by calendar month, regardless of year.
  • Date Claim Payment Post.Year Value: Selecting this value will break out the included claim payment(s) by year, with no additional breakdown.
• Patient: Patient demographics information which applies to the included claim(s)
  • Patient City – Patient Zip Code: This will provide the patient's city of residence on the included claim(s), and will further break down to the patient's zip code, then patient chart number.
  • Patient City
  • Patient Address 1
  • Patient Address 2
  • Patient Birth Date
  • Patient Chart: Patient Chart Number, but hovering over chart number will tooltip additional patient demographic information 
  • Patient Employment Status
  • Patient External ID:
  • Patient First Name
  • Patient Full Name (First Name Last Name) 
  • Patient Gender
  • Patient is Active: Active Checkbox in Patient Setup is checked
  • Patient is Living: RHC Date field is blank in Patient Setup
  • Patient is Reportable: Reportable Checkbox in Patient Setup is checked
  • Patient Label: Patient Demographics which could be used to print an address label.
  • Patient Last Name
  • Patient Marital Status
  • Patient Reverse Name: Last name, First name
  • Patient RHC Date: Patient Date of Death – Respirations Have Ceased
  • Patient State
  • Patient Suffix Name
  • Patient Zip Code
  • Update Date: The last date any Patient Setup field was modified within the database.
• Payment or Adjustment: Used only with Fact Claim Payment data, this breaks out the amounts of payments vs. adjustments for the included payment(s).
  • Dim Payment Type: The Payment Type on the included payment(s), categorized by an iSalus internal unique identifier.
  • Payment Type Code: The Payment Type on the included payment(s), by code.
    • Adj = Adjustments, Pay = Payments
  • Payment Type Description: The Payment Type on the included payment(s), by text.
  • Update Date: The last date the description of the Payment Type was modified within the database.
• Payment Paid By: Used only with Fact Claim Payment data, this breaks out who are the payers on the included payment(s).
  • Dim Payment Paid By: The category of payer on the included payment(s), categorized by an iSalus internal unique identifier.
  • Payment Paid By Code: The category of payer on the included payment(s), by code.
    • * = Unknown, PAT = Patient, PYR = Payer, RSP = Responsible Party
  • Payment Paid By Description: The category of payer on the included payment(s), by text.
  • Update Date: The last date the Payment Paid By was modified within the database.
• Posting Method: Used only with Fact Claim Payment data, this breaks out the payment method(s) used to make the included payment(s), such as cash, check, credit card, etc.
  • Dim Posting Method: The posting method(s) on the included payment(s), categorized by an iSalus internal unique identifier.
  • Posting Method Description: The posting method(s) on the included payment(s), by text.
  • Update Date: The last date the Posting (Payment) Method was modified within the database.
• Posting Type: Used only with Fact Claim Payment data, this breaks out the payment or adjustment type(s) for the included payments, such as Insurance Check, Co-Pay, Courtesy Write-Off, etc.
  • Dim Posting Type: The posting type(s) on the included payments/adjustments, categorized by an iSalus internal unique identifier.
  • Posting Type Description: The posting method(s) on the included payment(s), by text.
  • Update Date: The last date the Posting (Payment) Type was modified within the database.
• Procedure: The current procedure(s), either CPT or HCPCS, on the included claim(s).
  • Dim Procedure: The procedure(s) on the included claim(s), categorized by an iSalus internal unique identifier.
  • Procedure Code: The procedure code(s) on the included claim(s).
  • Procedure Code Description: Both the procedure alphanumeric code(s) and the text description for the included claim(s).
  • Procedure Description: The text description for any procedure code(s) on the included claim(s).
  • Procedure Group: The Code Class assigned to each CPT/HCPCS code(s) on the included claim(s).
  • Procedure Modifier: Modifiers used with procedures on the included claim(s).
  • Procedure POS: The Place of Service assigned to each CPT/HCPCS code(s) at the procedure code level on the included claim(s), by text description.
  • Update Date: The last date the Procedure Code was modified within the database.
• Provider Alternate: The Alternate Provider (if any) currently on the included claim(s).
  • Additional Provider Fields (some self-explanatory); all fields apply only to included claim(s):
    • Provider Alternate.Dim Provider: The Alternate Provider on the included claim(s), categorized by an iSalus internal unique identifier.
    • Provider Alternate.Provider City
    • Provider Alternate.Provider DEA (alphanumeric value)
    • Provider Alternate.Provider First Name
    • Provider Alternate.Provider Full Name (First Name Last Name)
    • Provider Alternate.Provider Last Name
    • Provider Alternate.Provider Middle Name
    • Provider Alternate.Provider NPI (numeric value)
    • Provider Alternate.Provider NPI Name
    • Provider Alternate.Provider Reverse Name (Last Name, First Name)
    • Provider Alternate.Provider State
    • Provider Alternate.Provider Suffix Name
    • Provider Alternate.Provider Zip Code
    • Provider Alternate.Update Date: The last date the Provider was modified within the database.
• Provider Attending: The Attending Provider (if any) currently on the included claim(s).
  • Additional Provider Fields (some self-explanatory); all fields apply only to included claim(s):
    • Provider Attending.Dim Provider: The Attending Provider on the included claim(s), categorized by an iSalus internal unique identifier.
    • Provider Attending.Provider City
    • Provider Attending.Provider DEA (alphanumeric value)
    • Provider Attending.Provider First Name
    • Provider Attending.Provider Full Name (First Name Last Name)
    • Provider Attending.Provider Last Name
    • Provider Attending.Provider Middle Name
    • Provider Attending.Provider NPI (numeric value)
    • Provider Attending.Provider NPI Name
    • Provider Attending.Provider Reverse Name (Last Name, First Name)
    • Provider Attending.Provider State
    • Provider Attending.Provider Suffix Name
    • Provider Attending.Provider Zip Code
    • Provider Attending.Update Date: The last date the Provider was modified within the database
• Provider Ordering: The Ordering Provider (if any) currently on the included claim(s).
  • Additional Provider Fields (some self-explanatory); all fields apply only to included claim(s):
    • Provider Ordering.Dim Provider: The Ordering Provider on the included claim(s), categorized by an iSalus internal unique identifier.
    • Provider Ordering.Provider City
    • Provider Ordering.Provider DEA (alphanumeric value)
    • Provider Ordering.Provider First Name
    • Provider Ordering.Provider Full Name (First Name Last Name)
    • Provider Ordering.Provider Last Name
    • Provider Ordering.Provider Middle Name
    • Provider Ordering.Provider NPI (numeric value)
    • Provider Ordering.Provider NPI Name
    • Provider Ordering.Provider Reverse Name (Last Name, First Name)
    • Provider Ordering.Provider State
    • Provider Ordering.Provider Suffix Name
    • Provider Ordering.Provider Zip Code
    • Provider Ordering.Update Date: The last date the Provider was modified within the database.
• Provider Purchasing: The Purchasing Provider (if any) currently on the included claim(s).
  • Additional Provider Fields (some self-explanatory); all fields apply only to included claim(s):
    • Provider Purchasing.Dim Provider: The Purchasing Provider on the included claim(s), categorized by an iSalus internal unique identifier.
    • Provider Purchasing.Provider City
    • Provider Purchasing.Provider DEA (alphanumeric value)
    • Provider Purchasing.Provider First Name
    • Provider Purchasing.Provider Full Name (First Name Last Name)
    • Provider Purchasing.Provider Last Name
    • Provider Purchasing.Provider Middle Name
    • Provider Purchasing.Provider NPI (numeric value)
    • Provider Purchasing.Provider NPI Name
    • Provider Purchasing.Provider Reverse Name (Last Name, First Name)
    • Provider Purchasing.Provider State
    • Provider Purchasing.Provider Suffix Name
    • Provider Purchasing.Provider Zip Code
    • Provider Purchasing.Update Date: The last date the Provider was modified within the database.
• Provider Referring: The Referring Provider (if any) currently on the included claim(s).
  • Additional Provider Fields (some self-explanatory); all fields apply only to included claim(s):
    • Provider Referring.Dim Provider: The Referring Provider on the included claim(s), categorized by an iSalus internal unique identifier.
    • Provider Referring.Provider City
    • Provider Referring.Provider DEA (alphanumeric value)
    • Provider Referring.Provider First Name
    • Provider Referring.Provider Full Name (First Name Last Name)
    • Provider Referring.Provider Last Name
    • Provider Referring.Provider Middle Name
    • Provider Referring.Provider NPI (numeric value)
    • Provider Referring.Provider NPI Name
    • Provider Referring.Provider Reverse Name (Last Name, First Name)
    • Provider Referring.Provider State
    • Provider Referring.Provider Suffix Name
    • Provider Referring.Provider Zip Code
    • Provider Referring.Update Date: The last date the Provider was modified within the database.
• Provider Rendering: The Rendering Provider currently on the included claim(s).
  • Additional Provider Fields (some self-explanatory); all fields apply only to included claim(s):
    • Provider Rendering.Dim Provider: The Rendering Provider on the included claim(s), categorized by an iSalus internal unique identifier.
    • Provider Rendering.Provider City
    • Provider Rendering.Provider DEA (alphanumeric value)
    • Provider Rendering.Provider First Name
    • Provider Rendering.Provider Full Name (First Name Last Name)
    • Provider Rendering.Provider Last Name
    • Provider Rendering.Provider Middle Name
    • Provider Rendering.Provider NPI (numeric value)
    • Provider Rendering.Provider NPI Name
    • Provider Rendering.Provider Reverse Name (Last Name, First Name)
    • Provider Rendering.Provider State
    • Provider Rendering.Provider Suffix Name
    • Provider Rendering.Provider Zip Code
    • Provider Rendering.Update Date: The last date the Provider was modified within the database.
• Provider Supervising: The Supervising Provider (if any) currently on the included claim(s).
  • Additional Provider Fields (some self-explanatory); all fields apply only to included claim(s):
    • Provider Supervising.Dim Provider: The Supervising Provider on the included claim(s), categorized by an iSalus internal unique identifier.
    • Provider Supervising.Provider City
    • Provider Supervising.Provider DEA (alphanumeric value)
    • Provider Supervising.Provider First Name
    • Provider Supervising.Provider Full Name (First Name Last Name)
    • Provider Supervising.Provider Last Name
    • Provider Supervising.Provider Middle Name
    • Provider Supervising.Provider NPI (numeric value)
    • Provider Supervising.Provider NPI Name
    • Provider Supervising.Provider Reverse Name (Last Name, First Name)
    • Provider Supervising.Provider State
    • Provider Supervising.Provider Suffix Name
    • Provider Supervising.Provider Zip Code
    • Provider Supervising.Update Date: The last date the Provider was modified within the database.
• Service Location: The Service Location currently on the included claim(s). Most fields are self-explanatory.
  • Dim Service Location: The Service Location on the included claim(s), categorized by an iSalus internal unique identifier.
  • Service Location City
  • Service Location Name
  • Service Location State
  • Service Location Type: Facility, Lab, Other
  • Service Location Zip Code
  • Update Date: The last date the Service Location was modified within the database.

Here are some sample reports that you can produce with Billing Analytics:

Charges by Month by Rendering Provider:

1. First, drag the desired fields to the PivotTable areas:
   
   
   
2. Next, apply the desired service date filter by clicking on the filter icon where the filter is listed at the top of the report:
   
   
   
3. You can now see the desired output, charges by month by rendering provider filtered to the desired date range:
   
   

Payments by Financial Class by Payment Type for Post Date Range

1. First, drag the desired fields to the PivotTable areas:
   
   
   
2. Next, apply the desired service date filter by clicking on the filter icon where the filter is listed at the top of the report:
   
   
   
3. You can now see the payments by financial class by payment type, filtered to the desired posting date range:
   
   

Payments by Location by CPT Group

1. First, drag the desired fields to the PivotTable areas:
   
   
   
2. Next, apply the desired service date filter by clicking on the filter icon where the filter is listed at the top of the report:
   
   
   
3. You can now see the payments by location by CPT Group, filtered to the desired posting date range: