Invoice report vs multi day and multi production report

[eyecanseedoc]

If I add up patient payment and the insurance payment on the invoice report this does not equal any of the totals on either multi day/prod reports. I cannot figure out why...the total billed is correct but the rest is pretty much off.

[friscoeyeassociates]

So, it can be confusing at first. The "Patient Payment" and "Insurance Payment" categories on the Invoice Report are not necessarily corresponding vectors for "Total Billed" (AKA Fee By Production Group) on Production Reports... Rather, they are corresponding vectors for the section labeled "Deposits and Other Earned Income" on the Production Reports. Even still, you may see some fluctuation in these numbers across the two reports because even though both reports reference Invoices for their data, they do so in different ways. The invoice report is designed to give you a live breakdown of each invoice for a given time period and the associated fee distributions across each of them individually in specific categories. Within this report you can also isolate by insurance company and CMS file status. You can see how this may be useful for assessing payment breakdowns on a per insurance and per invoice basis, or for quickly seeing the CMS status of invoices on a given day/week.. The Production reports on the other hand reference invoice data to paint a different picture, which is that of a robust and broad overview of production for a given time period. Thus, this report breaks down data into different categories that may or may not be represented in the same way on the Invoice Report. For instance, on the production report you will see a receivables category towards the bottom. Here you will see all the money still owed to you by insurance companies and patients, some of which will be paid and some written off. The Invoice report will show you an amount paid or an amount written off for a particular invoice but it does not necessarily tell you that you are still owed money, and if so how much. You would have to infer that given the difference between Total Billed, and what you were paid/written off... While you can glean some insight into production from the Invoice report, the Production report will do the work for you and isolate the important monetary metrics that you want in a broad overview. I hope this helps clarify 

[docrothberg]

To stem off the question, If I want to see what was ACTUALLY paid to us based on production (ex. pt pays half upon ordering glasses and half upon picking them up on different days but to the same invoice, but the insurance hasn't processed yet), I would need to reference the Invoice Report and combine the insurance paid and patient paid columns together, right? Is there a corresponding place in the Production Report to see this or does the Production Report always include the total amount submitted to the insurance, which is an inflated and unrealistic number.

I like to run monthly reports and have been using the Invoice Report to calculate the ACTUAL production for the whole practice. If there's a quicker way then adding the insurance paid and patient paid column to save me time in another report, that'd be great.

[friscoeyeassociates]

"Net Revenue" on the Production/Multi-day Production is the number that reflects your actual "Operating Income". This is money you receive. This includes patient and insurance payers. The problem, whether you use Invoice Report or Production Report, is that Insurance payments usually take some time to come in. So if you are running reports April 1 for the month of March, your reports, no matter which you run, will be inaccurate in regards to "Net Revenue". There are ways to estimate incoming payments based on average payer values and industry norms given you have an experienced insurance coder filing claims for you. A typical rule of thumb for private optometry practice is a 60/40 split on average. Meaning if full retail cost is $100, then practice can expect to receive $60 from Payers and writing off the remaining $40. That is on average across all billable items. I will go into more detail on the attached pdf in regards to how I read the production reports. Hopefully its helpful for explaining how I think this report is useful. I utilize the Multi Day Production report for most of the accounting and overall numbers tracking. I utilize other reports such as the invoice report for more detailed, individual digging on particular dates or particular insurances. I don't use Invoice Report all too often to be completely honest. Production report on the other hand is a daily read because it really does give a barometer of how the day/month went even if I know ahead of time that not all insurance has been paid... I can do this because I have tracked our Net Rev to Total Billed percentage for a long time and I know we are consistently within a 1.5% error margin of that 60% average. At any given time I can run production report, see our total billed for that given day/week/month and know that our take home is going to be 60% of total billed give or take 1.5% error margin. Now, a 1.5% margin for an office our size can be to the tune of 15k or more, so my job doesn't stop there. I still need to, in the long term, drill down and make sure we are as efficient and error less as possible, but if your looking for a quick glance each day or month, 60% of total billed is a good place to start. If you find that you are consistently well below that 60% mark after all claims and payments are accounted for then its a sure sign there is most likely an issue in the billing department where things are getting mishandled. That 60% Net Rev to Total Billed is definitely something every practice should be paying attention to IMO... Below I will attach our March Production Report for 2019 with an in depth explanation. I will also post the March 18 vs March 19 numbers so you can see how, over time, the numbers change dramatically in a couple of key areas most notably "Recievables" and "Net Revenue" because March 2018 insurance Claims have all been paid while we are still waiting for many March 2019 payments.

** I do export my reports to excel so I can organize the printout into a more readable format. Each line is exactly as it appears on the normal Crystal report, and in the same order top to bottom, it just looks neater because, well, I prefer it that way haha.

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[docrothberg]

Thank you for that detailed and well written explanation. That 60% estimation is going to be incredibly helpful to me too. I really appreciate it.