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Effective Intelligence Power BI Report Training Definitions

Power Bi is an analytic tool designed by MedEvolve to allow practices to have real time insight into key metrics. It allows the end user to quickly diagnosis the health of the practice based on financial metrics.

 

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MedEvolve Ei Vault

Effective Intelligence

  1. Service Location – List of Service Location in which claims are sent out for
  2. Visit Count – Total number of visits in which claims were billed
  3. Visit Resolution % - Percentage of visits assigned to a representative that were successfully resolved. [Visit that received an insurance payment within 60 days of the first action taken] / [Assigned Visits]
  4. Zero Touch Visits % - Percentage of total visits that required no touches. [Visits without an Edit, Denial, Refile, or AR Action] / [Total Visits]
  5. Collection Effectiveness % - Percentage of collections out of expected collections on assigned visits. [Realized Gross Collections on Assigned Visits] / [Expected Gross Collections on Assigned Visits]
  6. Exhausted Visit % - Percentage of Visits that have been touched 5 or more times. [Visits with 5 or more touches] / [Assigned Visits]
  7. 7At Risk % - Percentage of outstanding AR that needs special attention. [Open Balance Insurance Visits with a balance >$25, has had no Insurance Payment, and hasn’t been touched in 90 days] / [Open Balance Insurance Visits]
  8. Work Effort Rate – Average touches it takes to receive a successful resolution. [Action Taken] / [Assigned Visits]

Zero Touch Visits

  1. Service Location – List of Service Locations in which claims are sent out for
  2. Visit Count – Total number of visits in which claims were billed
  3. Zero Touch Visits % - Percentage of visits assigned to a representative that were successfully resolved. [Visit that received an insurance payment within 60 days of the first action taken] / [Assigned Visits]
  4. Edited Visits % - Percentage of visits that required a representative to correct an Edit (unprocessables, invalid, or reject)
  5. Refiled Visits % - Percentage of visits that required a representative to refile the claim with the payer for any reason.
  6. Denied Visits % - Percentage of visits that required a representative to resolve or attempt a denial received on the visit.
  7. Action Visits % - Percentage of visits that required a representative to take any action on the claim to get the visit paid.

  8. Task Visits % - Percentage of visits that required a representative to create a task for additional help or information to get the visit paid.

Work Effort Rate

  1. Service Location – List of Service Locations in which claims are sent out for
  2. Visit Count – Total number of visits in which claims were billed
  3. Work Effort Edit Rate – Average number of times a claim is touched for a unprocessables, invalid or rejection edit worked.
  4. Work Effort Refile Rate – Average number of times a claim is touched to refile the claim with the payer.
  5. Work Effort Denial Rate - Average number of times a claim is touched a denial on the claim.
  6. Work Effort Action Rate – Average number of times a claim is touched in Workflow for Insurance AR Follow Up to get the claim paid.
  7. Work Effort Task Rate – Average number of times a task is touched from another department for clarification to assist in resolving the claim in Workflow.

MedEvolve RCM Scorecard

Key Metrics

  1. Charge Lag – Office – The average number of days that pass between the Service Date and the first charge postdate on the visit. Benchmark is 2 days.
  2. Charge Lag – Other – The average number of days that pass between the Service Date and the first charge postdate on the visit. Benchmark is 5 days.
  3. Visits – The number of visits for the month.
  4. New Patient Visits % - Percentage of visits that recorded a new patient procedure code (90791, 90792, 99201, 99202, 99203, 99204, 99205, 99217, 99218, 99219, 99220, 99221, 99222, 99223, 99234, 99235, 99236, 99238, 99239, 99241, 99242, 99244, 99245, 92002, 92004, 92070) [New Patient Visit Count] / [Visit Count]
  5. OTC Collections / Office Visit – The average collection from a patient per visit at an office location. OTC Collection are Private Payments posted within 7 days of the Service Date. [OTC Collections Office] / [Office Visit Count]
  6. OTC Collections / Other Visit - The average collection from a patient per visit at a surgery location. OTC Collection are Private Payments posted within 7 days of the Service Date. [OTC Collections Other] / [Other Visit Count]
  7. Unreconciled Appt % - Completed appointments that do not have a matching charge based on Patient Service Date. [Unreconciled Appt. Count] / [Completed Appt. Count]
  8. Complete Write Off – Visits that have gone to a $0 balance, had more than $0 charges, and were the sum of charges equal the sum of adjustments
  9. Encounters w Edits – The number of encounters that received an edit response either from MedEvovle PM or Practice Insight Claim Scrubber.
  10. Edits Amount – The amount of claim that received an edit response either from MedEvovle PM or Practice Insight Claim Scrubber
  11. Denied Visits – The number of visits that denied
  12. Denied Amount – The amount of the claims that received a denial
  13. AR Debit Balance – The AR Debit Balance on all open AR
  14. AR Debit Opportunity – The estimated amount of revenue on existing AR based on the historic Gross Collection Ration of the primary insurance plan.
  15. AR Debit Denied % - The percentage of Debit AR that has received a Denial [Denied Debit AR] / [Debit AR]
  16. AR Debit > 60 Days % - The percentage of Debit AR still open 60 days after the Service Date [Denied AR >60 Days] / [Debit AR]
  17. AR Debit Insurance > 60 Days % - The percentage of Insurance Debit AR still open 60 days after the Service Date [Insurance Debit AR >60 Days] / [Insurance Debit AR]
  18. AR Debit Self Pay >60 Days % - The percentage of Self Pay Debit AR still open 60 days after the Service Date [Self Pay Debit AR >60 Days] / [Self Pay Debit AR]

  19. AR Days (1yr. avg) – The average number of days it takes a visit from the original Charge Post Date to the $0 balance date (1yr. avg) [Debit AR] / [Average Daily Charges ]

  20. AR Days (180 days avg) - The average number of days it takes a visit from the original Charge Post Date to the $0 balance date (180 days avg) [Debit AR] / [Average Daily Charges]
  21. AR Days (90 days avg) – The average number of days it takes a visit from the original Charge Post Date to the $0 balance date (90 days avg) [Debit AR] / [Average Daily Charges]
  22. AR Credit Balance – The amount of AR Credit Balance on the open AR

Charge Measures

  1. Control Month End Period – The Month of the Control End Period (which means the month in which the data was entered into the MedEvolve PM System)
  2. Charges – The total amount of charges entered during the Control Month End Period
  3. Payments – The total amount of payments entered during the Control Month End Period
  4. Insurance Payments – The total amount of insurance payments entered during the Control Month End Period
  5. Private Payments – The total amount of private payments entered during the Control Month End Period
  6. Adjustments – The total amount of the adjustments entered during the Control Month End Period
  7. Visit Count – The total visit count of the Control Month End Period
  8. Charge/Visit – The charges per visit for the Control Month End Period [Charges] / [Visit Count]
  9. Payment/Visit – The payments per visit for the Control Month End Period [Payments] / [Visit Count]
  10. Insurance Provider – The Insurance Provider associated with the data reflected
  11. CPT Group – The CPT Group associated with the data reflected
  12. Insurance Category – The Insurance Category associated with the data reflected

Collections Ratios

  1. Service Period – The Service Period is the actual DOS (date of service)
  2. Charges – The charges entered for the Service Period
  3. Payments – The payments entered for the Service Period
  4. GCR % (Gross Collection Ratio %) – The amount of revenue collected on charges so far [Total Payments] / [Total Charges]
  5. Contractual Adj – The contractual adjustments entered for the Service Period
  6. NCR % (Net Collection Ratio %) – The amount of revenue collected on the estimated allowable so far [Total Payments] / [Total Charges – Contractual Adjustments]
  7. Other Adjustments – The other adjustments entered for the Service Period.
  8. Bill – The patient responsibility amount for the claims of the Service Period.
  9. No Bill – The insurance responsibility amount for the claims of the Service Period.
  10. Insurance Provider – The Insurance Provider associated with the data reflected
  11. CPT Group – The CPT Group associated with the data reflected
  12. Primary Insurance Category – The Primary Insurance Category on the claims
  13. Monthly Averages – The average monthly values based on the 6 Service Periods starting 3 months ago

$0 Balances

  1. Control Month End Period – The Month of Control Month End Period (which means the month in which the data was entered into the MedEvolve PM System) of the final transaction that brought the Visit Balance to $0
  2. Charges - The total amount of charges entered for visits that went to a $0 Balance in the Control Month End Period
  3. Payments - The total amount of payments entered for visits that went to a $0 Balance in the Control Month End Period
  4. Visits - The total visits that went to a $0 Balance for the Control Month End Period
  5. GCR % (Gross Collection Ratio %) - The amount of revenue collected on charges so far [Total Payments] / [Total Charges]
  6. NCR% (Net Collection Ratio %) – The amount of revenue collected no the estimated allowable that went to a $0. [Total Payments] / [Total Charges – Contractual Adjustments]
  7. Complete Write Off – Visits that have gone to a $0 balance, had more than $0 charges, and were the sum of charges equal the sum of adjustments
  8. Contractual Adjustments – The Contractual adjustments entered for visits that went to a $0 Balance in the Control Month End Period
  9. Insurance Provider – The Insurance Provider entered for the Control Month End Period
  10. Last Denial Category – The Denial Category of the last denial that was posted on the claim before it went to $0 Balance
  11. Last Adjustment Category – The Adjustment Category of the last adjustment that was posted on the claim before it went to $0 Balance
  12. Primary Insurance Category – The Primary Insurance Category on the claim.

Work RVUs 

  1. Service Period – The Service Period is the actual DOS (date of service)
  2. Work RVUs – Total number of Work RVUs posted for the Service Period [calculation based on CMS Guidelines]
  3. wRVUs / Visit – Total number of wRVUs per visit for the Service Period [calculation based on CMS Guidelines]
  4. Charges- Total Charges that were posted for the Service Period [calculation based on CMS Guidelines]
  5. Charges / wRVUs – Total Charges per wRVU posted for the Service Period [calculation based on CMS Guidelines]
  6. Payments – Total Payments that were posted for the Service Period [calculation based on CMS Guidelines]
  7. Payments / wRVUs – Total payments per wRVU posted for the Service Period [calculation based on CMS Guidelines]
  8. Total RVUs – Total RVUs posted for the Service Period [calculation based on CMS Guidelines]
  9. Insurance Provider – The insurance Provider associated with the data reflected
  10. POS Location Service Period – The POS Location (office or surgery [other]) for the Service Period
  11. Office Work RVUs – Total number of Office Work RVUs posted for the Service Period [calculation based on CMS Guidelines]
  12. Office wRVUs / Visit – Total number of Office wRVUs V’s posted for the Service Period [calculation based on CMS Guidelines]
  13. Office Charges / wRVU – Total Number of Office Charges RVUs posted for the Service Period [calculation based on CMS Guidelines]
  14. Office Payments / wRVU – Total number of Office Payments RVUs posted for the Service Period [calculation based on CMS Guidelines]
  15. Other Work RVUs – Total number of Other Work RVUs posted for the Service Period [calculation based on CMS Guidelines]
  16. Other wRVUs / Visit – Total number of Other wRVUs V’s posted for the Service Period [calculation based on CMS Guidelines]
  17. Other Charges / wRVU – Total number of Other Charges RVUs posted for the Service Period [calculation based on CMS Guidelines]
  18. Other Payments / wRVU – Total number of Other Payments RVUs posted for the Service Period [calculation based on CMS Guidelines]
  19. CPT Group – The CPT Group associated with the data reflected

Edits

  1. Claim Error – Pre-Claim errors from the Clearinghouse’s scrubber
  2. Claim Rejection – Pre-Claim payer edits as reported by the Clearinghouse
  3. Unprocessables – Claim edits from MedEvolve’s claim scrubber
  4. Edit Type – The type of the edit from either MedEvolve or Clearinghouse claims scrubber
  5. Edit Message – The edit message associated from the claims scrubber that the claim hit for
  6. Edits Amount – The amount of the edit that the claims scrubber that the claim hit for
  7. Insurance Name – The Insurance Name associated with the edit that the claim

Denials

  1. Denial Category – Category in which specific denial ANSI codes roll up to
  2. Insurance Provider – The Insurance Provider associated with the data reflected
  3. Denied Amount – The amount of the denial on the claim
  4. CPT Group – The CPT Group associated with the data reflected
  5. Insurance Category – The Insurance Category associated with the data reflected

Payer Mix Trending

  1. Change % - The percentage of charges by payer category for each month’s total charges
  2. Payment % - The percentage of payments by payer category for each month’s total payments
  3. Gross Collection Ration % - The amount of revenue collected on charges that reached a $0 Balance in each given month [Total Payments] / [Total Charges]

AR Liquidity

  1. AR Balance – The beginning AR balance for the month
  2. Charges – The total charges for the month
  3. Insurance Payments – The total insurance payments for the month
  4. Private Payments – The total private payments for the month
  5. UCR Write Off – The total UCR Write Off’s for the month
  6. Other Adjustments – The Total other adjustments for the month
  7. Change in AR – The Change in AR balance for the month
  8. Adjustment Category – The Adjustment Category in which specific adjustment codes roll up to
  9. Transaction Type – The type of transaction posted for the month
  10. AR Equation / Change in AR – [Charges – Payments – Adjustments = Change in AR]
  11. Transaction Categories – Expand each of the transaction categories to see which transaction codes roll up under each group.

AR Snapshot

  1. Current Insurance Category – The last known payer who is responsible for the visit
    1. a. Self Pay Primary – AR balances for visits that did not have insurance
    2. b. Self Pay Pass-Through – AR Balances for visits that started with insurance and have since been placed into patient responsibility
  2. Service Date Aging Buckets – Aging buckets here are AR balances aged since the Service Date
  3. Service Date 0-60 & 61+ - Aging of AR by Service date reflected 0-60 & 61+
  4. File Date Aging Buckets – Aging buckets here are AR balances aged since the File Date
  5. File Date 0-60 & 61+ - Aging of AR by File date reflected 0-60 & 61+
  6. Visit Entry Aging Buckets – Aging buckets here are AR balances aged since the Visit Entry
  7. Visit Entry 0-60 & 61+ - Aging of AR by Visit entry reflected 0-60 & 61+
  8. Bill Date Aging Buckets – Aging buckets here are the balance aged since the Bill Date
  9. Bill Date 0-30 & 31+ - Aging of AR by bill date reflected 0-30 &31+
  10. Last Insurance Payment Aging Buckets – Aging buckets here are AR balance aged since the Last Insurance Payment Date
  11. Last Insurance Payment 0-60 & 61+ - Aging of AR by Last payment reflected payment 0-60 & 61+
  12. Last Insurance Event Aging Buckets – Aging buckets here are AR balances aged since the Last Insurance Event Date
  13. Last Event 0-60 &61+ - Aging of AR by Last event reflected Event 0-60 & 61+
  14. Last Private Payment Aging Buckets – Aging buckets here are AR balances aged since the Last Private Payment date
  15. Last Private Payment 0-60 & 61+ - Aging of AR by Last payment reflected Payment 0-60 &61+
  16. Last Self Pay Event Aging Buckets – Aging buckets here are AR balances aged since the Last Self Pay Event Date
  17. Last Self Pay Event 0-60 & 61+ - Aging of AR by Last event reflected Self Pay Event 0-60 & 61+

AR Snapshot by Count

  1. Current Insurance Category – The last known payer who is responsible for the visit
    1. Self Pay Primary – AR balances for visits that did not have insurance
    2. Self Pay Pass-Through – AR Balances for visits that started with insurance and have since been placed into patient responsibility
  2. Service Date Aging Buckets – Aging buckets here are AR balances aged since the Service Date
  3. Service Date 0-60 & 61+ - Aging of AR by Service date reflected 0-60 & 61+
  4. File Date Aging Buckets – Aging buckets here are AR balances aged since the File Date
  5. File Date 0-60 & 61+ - Aging of AR by File date reflected 0-60 & 61+
  6. Visit Entry Aging Buckets – Aging buckets here are AR balances aged since the Visit Entry
  7. Visit Entry 0-60 & 61+ - Aging of AR by Visit entry reflected 0-60 & 61+
  8. Bill Date Aging Buckets – Aging buckets here are the balance aged since the Bill Date
  9. Bill Date 0-30 & 31+ - Aging of AR by bill date reflected 0-30 &31+
  10. Last Insurance Payment Aging Buckets – Aging buckets here are AR balance aged since the Last Insurance Payment Date
  11. Last Insurance Payment 0-60 & 61+ - Aging of AR by Last payment reflected payment 0-60 & 61+
  12. Last Insurance Event Aging Buckets – Aging buckets here are AR balances aged since the Last Insurance Event Date
  13. Last Event 0-60 &61+ - Aging of AR by Last event reflected Event 0-60 & 61+
  14. Last Private Payment Aging Buckets – Aging buckets here are AR balances aged since the Last Private Payment date
  15. Last Private Payment 0-60 & 61+ - Aging of AR by Last payment reflected Payment 0-60 &61+
  16. Last Self Pay Event Aging Buckets – Aging buckets here are AR balances aged since the Last Self Pay Event Date
  17. Last Self Pay Event 0-60 & 61+ - Aging of AR by Last event reflected Self Pay Event 0-60 & 61+

AR Trending

  1. Service Date Age Bucket – Service date Aging buckets
  2. Service Date Age Bucket 2 – Service date Aging buckets including 60+ or 0-60
  3. AR Balance – The AR Balance for the indicated Aging Bucket from the Service Date
  4. AR Balance % - The AR Balance % for the indicated Aging Bucket from Service Date
  5. Current Insurance Category – The Current Insurance Category

A/R Days

  1. POS Location – POS Location such as Office or Other (surgery)
  2. AR Bal – AR Balance
  3. AR Days 365 – AR Days calculated with 365 days’ worth of data [Debit AR] / [Average Daily Charges]
  4. AR Days 180 – AR Days calculated with 180 days’ worth of data [Debit AR] / [Average Daily Charges]
  5. AR Days 90- AR Days calculated with 90 days’ worth of data [Debit AR] / [Average Daily Charges]
  6. Primary Insurance Category – The Primary Insurance Category
  7. CPT Group – The CPT Group

Appointments

  1. Appt Status – The appointment status in MedEvolve PM
  2. Completed Appt – The number of appointments marked as Completed in the MedEvolve PM
  3. Unreconciled Appt % - The percentage of appointments that are on the schedule but do not have a corresponding charge posted on the claim [Unreconciled Appt. Count] / [Completed Appt. Count]
  4. Reconciled – The number of appointments that have a charge associated with the appointment
  5. Future Appt – The number of appointments scheduled for future months
  6. Previous Balance Appt – The number of appointments scheduled where the patient has an open Bill balance
  7. Previous Appt Balance – The Bill Balance owed by patients with appointments scheduled

Appointments by Source

  1. Primary Referring Provider – The primary referring provider associated with the appointment
  2. Primary Care Provider – The primary care provider associated with the appointment
  3. Referring Source – The referring source associated with the appointment
  4. Scheduled User – The user who scheduled the appointment

Filters for Appointments by Source Tab

  1. Appt Category – The appointment category associated with the appointment
  2. AR Balance – The balance of the AR you have the ability to choose a min or max
  3. Clinic Name – The Clinic names for the client
  4. Control Month End Period – The Control Month End Period Filter
  5. CPT Group- The CPT Groups to filter for the client
  6. CPT Group and Code – The CPT Groups to filter for the client
  7. Credit Debit – Choice for displaying data for either credits or debits
  8. Current Insurance Category – The Current insurance category to filter by
  9. Current Insurance Type – Choice for displaying data for either Insurance or Self Pay
  10. Custom Division – The divisions the client has identified to filter between
  11. Denial – Whether the message from the insurance company is considered a denial or not
  12. Denial _YN – AR balances that have had a denial entered or not
  13. Denial Category – The Category the denials can be filtered by
  14. Financial Location – The Financial Locations available to filter for the client
  15. First Pass Denial – The first time a specific denial code appears on a visit
  16. Insurance Payment _YN – AR balances that have either received an Insurance Payment or not
  17. Insurance Provider – The Insurance Provider available to filter for the practice
  18. Insurance Provider Specialty – The Specialty to filter for the Insurance Providers at the practice.
  19. Insurance Type – The current payer type responsible for the visit balance
  20. Open Charge_YN – AR balances that have had their charge entered but not yet posted or not
  21. Open Denial – Any denial on an open balance that has yet to receive and insurance payment
  22. Patient Credit Debit – AR balances for patients based on their total owed AR
  23. POS Location – Ability to filter for the Office visits or Surgery visits
  24. Primary Insurance Category – The Primary Insurance Category on the claims
  25. Primary Insurance Type – The Primary Insurance Type on the claims
  26. Remaining GCR – The percentage of remaining gross collections based on the Charge amount [Total Payments] / [Total Charges]
  27. Service Location – The Service Locations available to filter for the client
  28. Service Provider – The Service Provider available to filter for the practice
  29. Service Provider Specialty – The Specialty to filter for the Service Provider at the practice
  30. UCR Adjustment_YN – AR balances that have either received a denial or not

MedEvolve Billing Dashboard

  1. Rule Name – The name the rule from the scrubber in MedEvolve PM that reviews the claim prior to it going to the clearing house for Scrubbing.
  2. Count of Claim Key – The number of claims that hit the scrubbing edit.
  3. Claim Charges – The amount of the claim that hit the scrubbing edit.
  4. Insurance Provider – The insurance provider associated with the claim that hit the scrubbing edit
  5. Primary Insurance Name – The primary insurance associated with the claim that hit the scrubbing edit
  6. Claim Date – The file date of the claim that hit the scrubbing edit
  7. File Type – The filing type of the claim that hit the scrubbing edit

MedEvolve Daily Operations

Current Month thru Previous Day

  1. Clinic Name – The clinic names for the client
  2. Previous Day Debit Charges – The total charges that were posted to a closed control yesterday
  3. Current Month Total Charges – The total charges that have been posted to a closed control MTD
  4. Previous Day Total Payments – The total payments that were posted to a closed control yesterday
  5. Current Month Total Payments – The total payments that were posted to a closed control MTD
  6. Max Service Date – At least one charge has been posted for services from the date reflected
  7. Max Surgery Date – At least one charge has been posted for surgeries from the date reflected
  8. Max Procedure Date – At least one charge has been posted for the procedures from the date reflected
  9. Max Control Process Date – At least one control for charges has been posted/closed from the date reflected
  10. ERA not Processed – Dollar amount of total ERAs that have not been marked as processed
  11. DOS Debit Charges –
  12. Open Charges – Charges that are posted in an open control
  13. Open Payments – Payments that are posted in an open control.

Daily Operations Summary – Previous Month

  1. ERA not Processed – Dollar amount of total ERAs that have not been marked as processed
  2. ERA not Processed Count – Number of ERAs that have not been marked as processed
  3. DOS Debit Charges –
  4. Open Charges – Charges that posted in an open control
  5. Open Payments – Payments that are posted in an open control

Daily Operations Summary – Year through Prior Month

  1. ERA Not Processed – Dollar amount of total ERAs that have not been marked as processed
  2. ERA Not Processed Count – Number of ERAs that have not been marked as processed
  3. DOS Debit Charges –
  4. Open Charges – Charges that are posted in an open control
  5. Open Payments – Payments that are posted in an open control

Daily Operations Summary – Prior vs Current Month

  1. Clinic Name – The clinic names for the client
  2. Current Month Charges – The total charges that have been posted to a closed control MTD
  3. Previous Month Charges – The total charges that have been posted to a closed control for the previously EOM Control Period
  4. Percentage of Last Month – Percentage of current months charges to previous month charges that have been posted to a closed control
  5. Open Charges – Charges that are posted in an open control
  6. Max Service Date – At least one charge has been posted for services from the date reflected
  7. Max Surgery Date – At least one charge has been posted for surgeries from the date reflected

MedEvolve Inbound Queue

  1. Date Received – Date the charge was received via interface from EMR to Inbound Queue for processing.
  2. Count – Number of transactions
  3. Age – How old the transactions are from DOS
  4. Insurance Provider – Provider who provided the service and should be on the claim
  5. Primary Insurance Category – Primary Insurance Category associated with claim
  6. CPT Category – CPT Category for the charges on the claim

MedEvolve Payment Lag Analysis

  1. Primary Insurance Category – The primary insurance category associated with the payment.
  2. Payer Response YN –
  3. Denial YN – Filter options for payments for denials vs not denied
  4. Finical Location – The Financial Location in which the payment is associated with
  5. Service Location – The Service Location in which the payment is associated with

MedEvolve PM User Productivity

Overview

  1. PT User – The user name for the representative in the PM.
  2. Total Worked Per Day – The total number of transactions worked for the day
  3. Count of Day Worked –
  4. Total Count – The total count of transactions worked
  5. Total Count Manual – The total count of transactions that were entered in manually to the PM
  6. Total Count Electronic – The total count of transactions that were entered via an interface to the inbound queue in the PM
  7. Charge Count – The total count of charges that were entered
  8. Charge Count Manual – The total count of charges that were entered in manually to the PM
  9. Charge Count Electronic – The total count of charges that were entered in via an interface to the inbound queue in the PM
  10. Payment Count – The total count of payments that were entered
  11. Payment Count Manual – The total count of payments that were entered in manually to the PM
  12. Payment Count Electronic – The total count of payments that were entered in via an interface to the inbound queue in the PM
  13. Adjustment Count – The total adjustments that were entered
  14. Adjustment Count Manual – The total adjustments that were entered in manually to the PM
  15. Adjustment Count Electronic – The total adjustments that were entered in via an interface to the inbound queue in the PM

Overview by User

  1. PT User – The user name for the representative in the PM

Weekly View

  1. Hours Worked – The hour during the day in which transactions were entered into the PM
  2. PT User – The user name for the representative in the PM
  3. Week Worked – The Week Ending date for the transactions that were posted and worked.

MedEvolve Workflow AR Snapshot

AR Snapshot

  1. Clinic Name – The clinic names for the client.
  2. No Actions – No Actions – Aging from last time the claims was touched in the Workflow Tool
  3. 000-030 days – 000-030 days - Aging from last time the claims was touched in the Workflow Tool
  4. 031-060 days – 031-060 days - Aging from last time the claims was touched in the Workflow Tool
  5. 061-090 days – 061-090 days - Aging from last time the claims was touched in the Workflow Tool
  6. 091-120 days – 091-120 days - Aging from last time the claims was touched in the Workflow Tool
  7. 121-150 days – 121-150 days - Aging from last time the claims was touched in the Workflow Tool
  8. 151-180 days – 151-180 days - Aging from last time the claims was touched in the Workflow Tool
  9. 181-365 days – 181-365 days - Aging from last time the claims was touched in the Workflow Tool
  10. Visits - Total Number of Visits
  11. AR Balance – Total AR Balance of Visits
  12. Opportunity – Total Cash Opportunity of Visits
  13. Charges – Total Charges of Visits
  14. Insurance Payments – Total Insurance Payments of Visits
  15. Private Payments – Total Private Payments of Visits
  16. Adjustments – Total Adjustments of Visits
  17. Last Claim Activity – Last Claim Activity chosen in WF by representative on claim worked
  18. Last Claim Status – Last Claim Status chosen in WF by representative on claim worked
  19. Last Claim Action – Last Claim Action chosen in WF by representative on claim worked
  20. Clinic Name – The clinic names for the client
  21. Visit Entry Age Bucket – The age of the account from date of service
  22. Ins Payment_YN – Filter for if the claim has received an insurance payment or not
  23. Denial_YN – Filter for if the claim has received a denial or not
  24. AR Balance – Filter to set AR Balance thresholds
  25. Remaining GCR – Filter to set GCR thresholds
  26. Unique User Actions – Filter to set number unique user action (i.e. how many times a representative has worked an account)

AR Snapshot by Last Action User

  1. Last Claim Action Representative –
  2. No Actions – No Actions – Aging from last time the claims was touched in the Workflow Tool
  3. 000-030 days – 000-030 days - Aging from last time the claims was touched in the Workflow Tool
  4. 031-060 days – 031-060 days - Aging from last time the claims was touched in the Workflow Tool
  5. 061-090 days – 061-090 days - Aging from last time the claims was touched in the Workflow Tool
  6. 091-120 days – 091-120 days - Aging from last time the claims was touched in the Workflow Tool
  7. 121-150 days – 121-150 days - Aging from last time the claims was touched in the Workflow Tool
  8. 151-180 days – 151-180 days - Aging from last time the claims was touched in the Workflow Tool
  9. 181-365 days – 181-365 days - Aging from last time the claims was touched in the Workflow Tool
  10. Visits - Total Number of Visits
  11. AR Balance – Total AR Balance of Visits
  12. Opportunity – Total Cash Opportunity of Visits
  13. Charges – Total Charges of Visits
  14. Insurance Payments – Total Insurance Payments of Visits
  15. Private Payments – Total Private Payments of Visits
  16. Adjustments – Total Adjustments of Visits
  17. Last Claim Activity – Last Claim Activity chosen in WF by representative on claim worked
  18. Last Claim Status – Last Claim Status chosen in WF by representative on claim worked
  19. Last Claim Action – Last Claim Action chosen in WF by representative on claim worked
  20. Clinic Name – The clinic names for the client
  21. Visit Entry Age Bucket – The age of the account from date of service
  22. Ins Payment_YN – Filter for if the claim has received an insurance payment or not
  23. Denial_YN – Filter for if the claim has received a denial or not
  24. AR Balance – Filter to set AR Balance thresholds
  25. Remaining GCR – Filter to set GCR thresholds
  26. Unique User Actions – Filter to set number unique user action (i.e. how many times a representative has worked an account)

AR Snapshot by Payer Category

  1. Clinic Name – The clinic names for the client.
  2. No Actions – Aging from last time the claims was touched in the Workflow Tool
  3. 000-030 days – Aging from last time the claims was touched in the Workflow Tool
  4. 031-060 days – Aging from last time the claims was touched in the Workflow Tool
  5. 061-090 days – Aging from last time the claims was touched in the Workflow Tool
  6. 091-120 days – Aging from last time the claims was touched in the Workflow Tool
  7. 121-150 days – Aging from last time the claims was touched in the Workflow Tool
  8. 151-180 days – Aging from last time the claims was touched in the Workflow Tool
  9. 181-365 days – Aging from last time the claims was touched in the Workflow Tool
  10. Visits - Total Number of Visits
  11. AR Balance – Total AR Balance of Visits
  12. Opportunity – Total Cash Opportunity of Visits
  13. Charges – Total Charges of Visits
  14. Insurance Payments – Total Insurance Payments of Visits
  15. Private Payments – Total Private Payments of Visits
  16. Adjustments – Total Adjustments of Visits
  17. Last Claim Activity – Last Claim Activity chosen in WF by representative on claim worked
  18. Last Claim Status – Last Claim Status chosen in WF by representative on claim worked
  19. Last Claim Action – Last Claim Action chosen in WF by representative on claim worked
  20. Clinic Name – The clinic names for the client
  21. Visit Entry Age Bucket – The age of the account from date of service
  22. Ins Payment_YN – Filter for if the claim has received an insurance payment or not
  23. Denial_YN – Filter for if the claim has received a denial or not
  24. AR Balance – Filter to set AR Balance thresholds
  25. Remaining GCR – Filter to set GCR thresholds
  26. Unique User Actions – Filter to set number unique user action (i.e. how many times a representative has worked an account)

AR Snapshot by Denials

  1. Denial Category –
  2. No Actions – Aging from last time the claims was touched in the Workflow Tool
  3. 000-030 days – Aging from last time the claims was touched in the Workflow Tool
  4. 031-060 days – Aging from last time the claims was touched in the Workflow Tool
  5. 061-090 days – Aging from last time the claims was touched in the Workflow Tool
  6. 091-120 days – Aging from last time the claims was touched in the Workflow Tool
  7. 121-150 days – Aging from last time the claims was touched in the Workflow Tool
  8. 151-180 days – Aging from last time the claims was touched in the Workflow Tool
  9. 181-365 days – Aging from last time the claims was touched in the Workflow Tool
  10. Visits - Total Number of Visits
  11. AR Balance – Total AR Balance of Visits
  12. Opportunity – Total Cash Opportunity of Visits
  13. Charges – Total Charges of Visits
  14. Insurance Payments – Total Insurance Payments of Visits
  15. Private Payments – Total Private Payments of Visits
  16. Adjustments – Total Adjustments of Visits
  17. Last Claim Activity – Last Claim Activity chosen in WF by representative on claim worked
  18. Last Claim Status – Last Claim Status chosen in WF by representative on claim worked
  19. Last Claim Action – Last Claim Action chosen in WF by representative on claim worked
  20. Clinic Name – The clinic names for the client
  21. Visit Entry Age Bucket – The age of the account from date of service
  22. Ins Payment_YN – Filter for if the claim has received an insurance payment or not
  23. Denial_YN – Filter for if the claim has received a denial or not
  24. AR Balance – Filter to set AR Balance thresholds
  25. Remaining GCR – Filter to set GCR thresholds
  26. Unique User Actions – Filter to set number unique user action (i.e. how many times a representative has worked an account)

Filters AR Snapshot by Denials

  1. CPT Code – Specific CPT Codes
  2. CPT Group – CPT Group for which specific CPT codes Roll Up
  3. Current Worklist – Worklist Name in which the claim is currently assigned
  4. File Date Bucket – Aging of claim from the File Date
  5. Financial Location – Financial Location Name
  6. Insurance Category – Insurance Category in which specific Insurance Plans Roll Up
  7. Insurance Name – Insurance Plan Name
  8. Insurance Provider – Insurance Provider Name
  9. Last Claim Action Date Bucket – Ability to ONLY show you “no actions” Filter
  10. Opportunity – Cash Opportunity
  11. Service Location – Service Location Name
  12. Service Provider – Service Provider Name
  13. Worklist Category – Worklist Category i.e. denied, regular, system

MedEvolve Workflow Production

Weekly Employee Quick Summary

  1. Representative – Representative working accounts.
  2. Assigned Claims – Number of claims that qualify for worklists assigned to a representative
  3. Assigned AR Balance – Balance of claims that are assigned to a representative
  4. Worked Claims – Claims that have been worked by the representative
  5. Worked Claims % - The percent of claims worked by the representative
  6. Worked Claims Per Day – The average claims worked per day by the representative
  7. Unworked Claim Weeks – The number of weeks it would take the representative to get through accounts assigned to them based upon their 8 wk average.
  8. Avg Actions Per Claim – The average number of actions that a representative has taken on claims worked
  9. Avg Follow UP Days – The average days that the representative is pushing claims out for follow up
  10. Avg Claim Age – The average age of the claims from DOS
  11. Clinic Name – The name of the clinic
  12. Week End Date – Filter for Week Ending date for the work week
  13. Team, Representative – Filter for a team or representative
  14. Worklist Category – Filter for the worklist category (i.e. denial, regular, system)
  15. Claim Status – Filter for the Claim Status that was chosen by the representative when working a claim
  16. Current Worklist – Filter for the Current worklist in which the claim is qualifying for

Action Effectiveness

  1. Representative – Representative working accounts
  2. Claims Worked – Number of claims that have been worked by a representative
  3. Action Count – Number of Actions taken on the claim that have been worked by a representative
  4. Avg Follow Up Days – The average days that the representative is pushing claims out for follow up
  5. Avg Action Per Claim – The average number of actions that a representative has taken on claims worked
  6. Orig Claim Balance – The Original Claim Balance on the claims that have been worked by the representative
  7. Change in AR – The Change in AR on the claims that have been worked by the representative
  8. Ins Pay – The Insurance Payments received on the claims that have been worked by the representative
  9. Pri Pay – The Private Payments received on the claims that have been worked by the representative
  10. Con Adj – The Contractual Adjustments posted on the claims that have been worked by the representative
  11. Other Adj – The Other Adjustments posted on the claims that have been worked by the representative
  12. Clinic Name – The name of the clinic
  13. Week End Date – Filter for Week Ending date for the work week
  14. Team, Representative – Filter for a team or representative
  15. Worklist Category – Filter for the worklist category (i.e. denial, regular, system)
  16. Claim Status – Filter for the Claim Status that was chosen by the representative when working a claim
  17. Current Worklist – Filter for the Current worklist in which the claim is qualifying for

Action Effectiveness by Action Type

  1. Claim Action – The Claim Action that the representative has chosen when the representative worked the claim
  2. Claims Worked – Number of claims that have been worked by a representative
  3. Action Count – Number of Actions taken on the claim that have been worked by a representative
  4. Avg Follow Up Days – The average days that the representative is pushing claims out for follow up
  5. Avg Actions Per Claim – The average number of actions that a representative has taken on claims worked
  6. Orig Claim Balance – The Orignial Claim Balance on the claims that have been worked by the representative
  7. Ins Pay – The Insurance Payments received on the claims that have been worked by the representative
  8. Pri Pay – The Private Payments received on the claims that have been worked by the representative
  9. Other Adj – The Other Adjustments posted on the claims that have been worked by the representative
  10. Clinic Name – The name of the clinic
  11. Week End Date – Filter for Week Ending date for the work week
  12. Team, Representative – Filter for a team or representative
  13. Worklist Category – Filter for the worklist category (i.e. denial, regular, system)
  14. Claim Status – Filter for the Claim Status that was chosen by the representative when working a claim
  15. Current Worklist – Filter for the Current worklist in which the claim is qualifying for

Action Effectiveness by Status

  1. Claim Status – The Claim Status that the representative has chosen when the representative worked the claim
  2. Claims Worked – Number of Claims that have been worked by a representative
  3. Action Count – Number of Actions taken on the claim that have been worked by a representative
  4. Avg Follow Up Days – The average days that representative is pushing claims out for follow up
  5. Avg Actions Per Claim – The average number of actions that a representative has taken on claims worked
  6. Orig Claim Balance – The Original Claim Balance on the claims that have been worked by the representative
  7. Change in AR – The Change in AR on the claims that have been worked by the representative
  8. Ins Pay – The Insurance Payments received on the claims that have been worked by the representative
  9. Pri Pay – The Private Payments received on the claims that have been worked by the representative
  10. Con Adj – The Contractual Adjustments posted on the claims that have been worked by the representative
  11. Other Adj - The Other Adjustments posted on the claims that have been worked by the representative
  12. Clinic Name – The name of the clinic
  13. Week End Date – Filter for Week Ending date for the work week
  14. Team, Representative – Filter for a team or representative
  15. Worklist Category – Filter for the worklist category (i.e. denial, regular, system)
  16. Claim Status – Filter for the Claim Status that was chosen by the representative when working a claim
  17. Current Worklist – Filter for the Current worklist in which the claim is qualifying for

Action Effectiveness by Worklist

  1. Representative – The representative that worked the claim
  2. Claims Worked – Number of claims that have been worked by a representative
  3. Action Count – Number of Actions taken on the claim that have been worked by a representative.
  4. Avg Follow Up Days – The average days that representative is pushing claims out for follow up
  5. Avg Actions Per Claim – The average number of actions that a representative has taken on claims worked
  6. Orig Claim Balance – The Original Claim Balance on the claims that have been worked by the representative
  7. Change in AR – The Change in AR on the claims that have been worked by the representative
  8. Ins Pay – The Insurance Payments received on the claims that have been worked by the representative
  9. Pri Pay – The Private Payments received on the claims that have been worked by the representative
  10. Con Adj – The Contractual Adjustments posted on the claims that have been worked by the representative
  11. Other Adj - The Other Adjustments posted on the claims that have been worked by the representative
  12. Clinic Name – The name of the clinic
  13. Week End Date – Filter for Week Ending date for the work week
  14. Team, Representative – Filter for a team or representative
  15. Worklist Category – Filter for the worklist category (i.e. denial, regular, system)
  16. Claim Status – Filter for the Claim Status that was chosen by the representative when working a claim
  17. Current Worklist – Filter for the Current worklist in which the claim is qualifying for

Weekly Productivity Trending

  1. Representative – The representative that worked the claim
  2. Worked Claims – Number of claims that have been worked by a representative
  3. Worked Claims Per Day – Number of claims that have been worked per day by the representative
  4. Action Count – Number of Actions taken on the claim that have been worked by representative
  5. Change in AR – The Change in AR on the claims that have been worked by the representative
  6. Avg Follow Up Days – The average days that the representative is pushing claims out for follow up
  7. Clinic Name – The name of the clinic
  8. Week End Date – Filter for Week Ending date for the work week
  9. Team, Representative – Filter for a team or representative
  10. Worklist Category – Filter for the worklist category (i.e. denial, regular, system)
  11. Claim Status – Filter for the Claim Status that was chosen by the representative when working a claim
  12. Current Worklist – Filter for the Current worklist in which the claim is qualifying for

Daily User Productivity

  1. Representative – The representative that worked the claim
  2. Clinic Name – The name of the clinic
  3. Week End Date – Filter for Week Ending date for the work week
  4. Team, Representative – Filter for a team or representative
  5. Worklist Category – Filter for the worklist category (i.e. denial, regular, system)
  6. Claim Status – Filter for the Claim Status that was chosen by the representative when working a claim
  7. Current Worklist – Filter for the Current worklist in which the claim is qualifying for

MedEvolve Workflow User Tasks

Tasks Overview

  1. Completed Tasks – Tasks that have been marked as completed in workflow.
  2. In Progress Tasks – Tasks that are still in progress in workflow
  3. Cancelled Tasks – Tasks that have been marked as canceled in workflow
  4. Clinic Name – The Clinic Name
  5. 000-007 days – Aging from date of creation of Tasks in workflow 000-007 days
  6. 008-014 days – Aging from date of creation of Tasks in workflow 008-014 days
  7. 015-021 days – Aging from date of creation of Tasks in workflow 015-021 days
  8. 022-030 days – Aging from date of creation of Tasks in workflow 022-030 days
  9. 031-060 days – Aging from date of creation of Tasks in workflow 031-060 days
  10. 061-090 days – Aging from date of creation of Tasks in workflow 061-090 days
  11. 091-180 days – Aging from date of creation of Tasks in workflow 091-181 days
  12. 181-365 days – Aging from date of creation of Tasks in workflow 181-365 days
  13. Clinic Name – Filter for the Clinic Name
  14. Task Status – Filter for the Task Status (i.e. Cancelled, Complete, open)
  15. Task Department – Filter for the Task Department (i.e. the department who works the task)
  16. Task Category – Filter for the Task Category

Task Overview

  1.  Clinic Name – The Clinic Name
  2. Task Category – The Category of the Tasks
  3. Task Department – The Department that the Task is assigned to
  4. Clinic Name – Filter for the Clinic Name
  5. Task Status – Filter for the Task Status (i.e. Cancelled, Complete, open)
  6. Task Department – Filter for the Task Department (i.e. the department who works the task)
  7. Task Category – Filter for the Task Category

Task Completion Trending

  1. Clinic Name – The Clinic Name
  2. Task Category – The Category of the Tasks
  3. Task Department – The Department that the Task is assigned to
  4. Clinic Name – Filter for the Clinic Name
  5. Task Status – Filter for the Task Status (i.e. Cancelled, Complete, open)
  6. Task Department – Filter for the Task Department (i.e. the department who works the task)
  7. Task Category – Filter for the Task Category

Tasks by User

  1. Assigned To – The representative that the Task is assigned to in workflow
  2. Created by – The representative that created the Task in workflow
  3. Closed by – The representative that closed the Task in workflow
  4. Clinic Name – Filter for the Clinic Name
  5. Task Status – Filter for the Task Status (i.e. Cancelled, Complete, Open)
  6. Task Department – Filter for the Task Department (i.e. the department who works the task)
  7. Task Category – Filter for the Task Category

MedEvolve Workflow Overpayments Production

Weekly Productivity Trending

  1. Action User – The user in workflow who took action on the claim.
  2. Visit Count – The number of claims that the representative worked
  3. Action Count – The number of actions that the representative took on claims
  4. Insurance Payments After Action – Insurance Payments received after action that the representative took on the claim
  5. Change in AR After Action – Change in AR after action that the representative took on the claim
  6. Clinic Name – Filter for the Clinic Name
  7. Week End Date – Filter for the Week Ending date
  8. Team, Action User – Filter for the team and representative
  9. Claims Status – Filter for the Claim Status that the representative chosen in workflow
  10. Current Worklist – Filter for the Current Worklist the claim qualifies for

Action Effectiveness

  1. Action User – Representative working accounts
  2. Visit Count – Number of claims that have been worked by a representative
  3. Action Count – Number of Actions taken on the claim that have been worked by a representative
  4. Ins Pay – The Insurance Payments received on the claims that have been worked by the representative
  5. Pri Pay – The Private Payments received on the claims that have been worked by the representative
  6. Con Adj – The Contractual Adjustments posted on the claims that have been worked by the representative
  7. Other Adj – The Other Adjustments posted on the claims that have been worked by the representative
  8. Clinic Name – Filter for the Clinic Name
  9. Week End Date – Filter for the Week Ending date
  10. Team, Action User – Filter for the team and representative
  11. Claim Status – Filter for the Claim Status that the representative chosen in workflow
  12. Current Worklist – Filter for the Current Worklist the claim qualifies for

Action Effectiveness by Action Type

  1. Claim Action – The Action that the representative chose when working the account.
  2. Visit Count – Number of claims that have been worked by a representative
  3. Action Count – Number of Actions taken on the claim that have been worked by a representative
  4. AR Balance – The AR Balance on the claims worked by the representative
  5. Ins Pay – The Insurance Payments received on the claims that have been worked by the representative
  6. Pri Pay – The Private Payments received on claims that have been worked by the representative
  7. Con Adj – The Contractual Adjustments posted on the claims that have been worked by the representative
  8. Other Adj – The Other Adjustments posted on the claims that have been worked by the representative
  9. Clinic Name – Filter for the Clinic Name
  10. Week End Date – Filter for the Week Ending date
  11. Team, Action User – Filter for the team and representative
  12. Claim Status – Filter for the Claim Status that the representative chosen in workflow
  13. Current Worklist – Filter for the Current Worklist the claim qualifies for

Action Effectiveness by Status

  1. Claim Status – The Status that the representative chose when working the account.
  2. Visit Count – Number of claims that have been worked by a representative
  3. Action Count – Number of Actions taken on the claim that have been worked by a representative
  4. AR Balance – The AR Balance on the claims worked by the representative
  5. Ins Pay – The Insurance Payments received on the claims that have been worked by the representative
  6. Pri Pay – The Private Payments received on claims that have been worked by the representative
  7. Con Adj – The Contractual Adjustments posted on the claims that have been worked by the representative
  8. Other Adj – The Other Adjustments posted on the claims that have been worked by the representative
  9. Clinic Name – Filter for the Clinic Name
  10. Week End Date – Filter for the Week Ending date
  11. Team, Action User – Filter for the team and representative
  12. Claim Status – Filter for the Claim Status that the representative chosen in workflow
  13. Current Worklist – Filter for the Current Worklist the claim qualifies for

Action Effectiveness by Worklist

  1. Action User – The representative that worked the claim.
  2. Visit Count – Number of claims that have been worked by a representative
  3. Action Count – Number of Actions taken on the claim that have been worked by a representative
  4. AR Balance – The AR Balance on the claims worked by the representative
  5. Ins Pay – The Insurance Payments received on the claims that have been worked by the representative
  6. Pri Pay – The Private Payments received on claims that have been worked by the representative
  7. Con Adj – The Contractual Adjustments posted on the claims that have been worked by the representative
  8. Other Adj – The Other Adjustments posted on the claims that have been worked by the representative
  9. Clinic Name – Filter for the Clinic Name
  10. Week End Date – Filter for the Week Ending date
  11. Team, Action User – Filter for the team and representative
  12. Claim Status – Filter for the Claim Status that the representative chosen in workflow
  13. Current Worklist – Filter for the Current Worklist the claim qualifies for

Daily User Productivity

  1. Action User – The representative that worked the claim
  2. Claim Action – The Claim Action that the representative choose when working a claim
  3. Clinic Name – Filter for the Clinic Name
  4. Week End Date – Filter for the Week Ending date
  5. Team, Action User – Filter for the team and representative
  6. Claim Status – Filter for the Claim Status that the representative chosen in workflow
  7. Current Worklist – Filter for the Current Worklist the claim qualifies for

Insurance Overpayments

  1. Action User – The representative that worked the claim
  2. Action Count – The number of actions that the representative took on claims
  3. AR Balance – The AR Balance on the claims worked by the representative
  4. Claim Activity – The Claim Activity that the representative choose when working a claim
  5. Claim Status – The Claim Status that the representative choose when working a claim
  6. Claim Action – The Claim Action that the representative choose when working a claim
  7. Action – The number of times that an action was taken on a claim
  8. Visits – The number of claims that the representative worked
  9. AR Balance – The AR Balance on the claims worked by the representative