Metrics View


The Metrics View is an optional view of the data represented in the Revenue Cycle Wheel.  The data in this view is grouped into 5 categories: Claims, Deposits, Aging, Receipts, and Submissions. Included with each data point is a trending indicator.  This trending indicator is represented by an up arrow with a plus sign or down arrow with a minus sign designating if the numbers are higher or lower than the previous reporting period. Clicking on any of the data lines on the left side of the screen will refresh the pie chart to display the data specific to the selected section. This view gives the user an additional way to look deeper into the data represented on the billing dashboard.

Claims

The purpose of this section is to display billing metrics for unsubmitted and rejected claims.  Claim counts and total charges will be displayed for each category.  Next to each value will be a symbol showing the direction the value has went compared to the prior reporting period.  Double clicking on any row will display an analysis window allowing you to view the last ninety days of data.

  • Unsubmitted Claims - Claims that have not been submitted to any payer.  These claims need to batched and submitted for adjudication.
  • Rejected Claims - Claims that have been submitted and the payer or clearinghouse has returned a rejection.  These claims need to be corrected and resubmitted.
  • 365 Rejected Claims - Claims only in the last 365 days that have been submitted and the payer or clearinghouse has returned a rejection.  These claims need to be corrected and resubmitted.

Deposits

The purpose of this section is to display billing metrics for new deposits, displayed by deposit type. Deposit counts and total payments will be displayed for each category.  Next to each value will be a symbol showing the direction the value has went compared to the prior reporting period. Double clicking on any row will display an analysis window allowing you to view new deposit data. Deposits listed in this section are new deposits that are ready to be posted into the system and applied to claims 

  • New Deposits ERA - Deposits that have been downloaded or imported from a clearinghouse or payer. Posting ERA Deposits
  • New Deposits EOB - Deposits that have been manually entered by a user. Posting EOB Deposits

Aging

The purpose of this section is to display billing metrics for claim insurance and patient aging.  Claim counts and claim balance will be displayed for each category. Next to each value will be a symbol showing the direction the value has went compared to the prior reporting period. Double clicking on any row will display an analysis window allowing you to view the last ninety days of data. Claims listed in this section are claims that have been submitted to payer or insurance and are waiting for payment.

  • Client Aging Patient - Claims that were sent out to patient within the last 90 days.
  • Client Aging Insurance - Claims that were sent out to insurance within the last 90 days.

Receipts

The purpose of this section is to display billing metrics for unapplied receipts.  Receipt counts and receipt balance will be displayed for each category. Next to each value will be a symbol showing the direction the value has went compared to the prior reporting period. Double clicking on any row will open the receipts details window. Receipts listed in this section are receipts that have been entered into the system but have not yet been applied to a claim.

  • Unapplied Receipts - Receipts that have been entered into the system but have not yet been applied to a claim.

Submissions

The purpose of this section is to display billing metrics for unsubmitted claim batches. Batch counts and total charges will be displayed for each category. Next to each value will be a symbol showing the direction the value has went compared to the prior reporting period. Double clicking on any row will display an analysis window allowing you to view the last ninety days of data. Submissions in this section need to be reviewed and submitted to the payer.

  • Non-Processed Claims - Electronic claims that have been batched and are ready to be reviewed and sent to the clearinghouse.
  • Non-Processed HCFA - Paper claims that have been batched and are ready to reviewed, printed, and mailed to the payers.
  • Non-Processed Statements - Statement claims that have been batched and are ready to be reviewed and submitted to the processor or printed and mailed to the responsible parties.