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  • Hank
    replied
    Gross Production = Collections - (Contractual Adjustments + Bad Debt Write-offs).

    How high is your practice overhead?  I realize you rounded off your numbers, but collections of $355,000 seems low.  If you have 50% practice overhead, then you would bring in only $177,500 after expenses.

    Leave a comment:


  • ENT Doc
    replied
    I think the numbers were hypothetical, and did the OP say they were ENT?

    Leave a comment:


  • ZZZ
    replied
    Total collections seem pretty low for an ENT. Either you're not very busy (low RVU production), your payer mix sucks, and/or your revenue management (coding, billing, collecting) isn't great

    Compare to other ENTs to figure out the weak link.

    Leave a comment:


  • Ozarka
    replied
    Would those just be different terms for gross charges, gross collections, and net collections?

    Leave a comment:


  • Zaphod
    replied




    Thank you nephron. I looked over my last year’s figures. Again, I am being hypothetical here and rounding off:

     

    For 2018:

    Services: $855,000

    Payments: $355,000

    Adjustments: $545,500

    Number of Cases : 2850

    I realize that the adjustments and payments may have also been carried over from latter months in 2017. But for the sake of discussion and simplicity, if I billed 855K in 2018 and only received 355K, that’s pretty low! Correct? is 50-60% payment for services billed the actual average for docs? I hear that a lot…

    What do the adjustments of 545K really tell me?

     

     
    Click to expand...


    maybe, maybe not. You can bill whatever you want, you get paid according to a set contract or schedule. It could say you billed 90 billion and only got 355k and it wouldnt be any more of an issue, better or worse than billing 360 and getting 355.

    The funny numbers in medicine are wasted time and harmful to every participant in medicine, except for journalists making things look terrible.

    Leave a comment:


  • nephron
    replied
    thats typical.  my group submits bills for $700/month to see dialysis pts, no one pays 700 a month, medicare reimburses 220 per month, the 700 figure was arbitrary and came from my employers head.   I think the idea is just to bill more then everyone is willing to pay so that you get the maximum amount they are willing to pay?   Medical billing is nonsense.

    Leave a comment:


  • ENT Doc
    replied
    They don’t tell you anything unless you understand where the service charges are coming from and how much is from bad debt write offs. If your service charges are based on your practice’s rate but not a more nuanced negotiated rate then you’re going to see a big drop off. But the more important thing to know is, of the allowable charges, how much is still outstanding (understand your A/R). Also, pretend you’re in the last year of your practice and retired. You’d be not working for months but collecting income. It’s just the A/R lag you’re dealing with. The goal should be to shorten that as much as possible.

    Leave a comment:


  • sarcolema56pay@gmai
    replied
    Thank you nephron. I looked over my last year's figures. Again, I am being hypothetical here and rounding off:

     

    For 2018:

    Services: $855,000

    Payments: $355,000

    Adjustments: $545,500

    Number of Cases : 2850

    I realize that the adjustments and payments may have also been carried over from latter months in 2017. But for the sake of discussion and simplicity, if I billed 855K in 2018 and only received 355K, that's pretty low! Correct? is 50-60% payment for services billed the actual average for docs? I hear that a lot...

    What do the adjustments of 545K really tell me?

     

     

    Leave a comment:


  • nephron
    replied
    Yes, payments are what you actually received, services are what you charged.   Looking at services charged or rvus is just helpful in comparing you to other group members to see if you are doing more work but just collecting less due to your payer mix.  Also, not sure if you can look at June yet, there can be a several month delay between services charged and payment for some payers, prob more useful to look at 6 month to a year ago to see what was actually collected on your services charged.

    Leave a comment:


  • ACN
    replied
    What zzz said. Also talk with your cfo or group accountant.

    Leave a comment:


  • jacoavlu
    replied


    June 2019: Number of Cases = 270 Services = $65,000 Payments = $35,500 Adjustments  = $42,500 i have my figures per month, showing totals and projected totals for the year. So, to put it simply, I saw 270 patients in June. I billed $65K and got paid $35K. With the adjustments, we got paid $42.5K. Is that the gist??

    The $35.5k and $42.5k don't really relate to the 270 and $65k. Much of the $35k and $42.5k would be from cases (and charges) from prior months. At least that would be my assumption.

    Leave a comment:


  • ZZZ
    replied
    Your 'services' is more typically referred to as 'charges'. It's a blue sky number that you can set at whatever you want.

    'Adjustments' are what gets knocked off your blue sky charges number by insurance contracts, Medicare, etc.

    Your 'payments' is what you actually collected.

    Leave a comment:


  • ENT Doc
    replied
    I wouldn’t say you got paid 42.5k - that’s the adjustment.

    Leave a comment:


  • sarcolema56pay@gmai
    replied
    Dear Jacoavlu,

    Thanks for your explanation. The worksheet is prepared by our practice administrator and is emailed to all the docs once a month. I am given the year to date figures for the entire practice and figures for every doc (not just mine) . Our monthly and yearly figures are shown for the last 6 years or so for comparison.

    Leave a comment:


  • jacoavlu
    replied
    Good for you for taking the interest. Who prepares the worksheet? That person should be able to explain definitively.

    We follow similar numbers. Understand that it is likely that the figures apply to the month in question. But obviously payments and adjustments don’t necessarily correlate with the cases and charges for the same month. Simply payments that came in during the month, and adjustments entered during the month, likely from cases months ago.

    We track each month, running totals, and have prior year figures. Also A/R and cash balance in the practice account.

    We also track RVUs for each doc for the month and YTD, percent collections, average payment per procedure. With comparison figures from prior year.

    Leave a comment:

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