This article is initially available on our podcast. Click here to listen.
There are not only different types of reports, but there are also different audiences for reports. What does this mean? Well, essentially it depicts different tiers for reports. If you think about what a biller or a collector needs, that’s very different from what a billing manager might need or a head of a revenue cycle management department. Even the needs of an executive in a hospital or a system, a CFO, a CEO, whatever that particular function might be, is very different in terms of reporting and analysis. So we can think of this in some respects as operational, tactical, strategic types of reporting and analyses.
Which systems work best?
We’ve seen that most revenue cycle management systems tend to be better at basic operational reports than at the other categories. In other words, “Can it output a list of claims that need to be worked? Or are there certain categories or something like that? Or is it possible to kick out a report that allows you to easily filter and say, “Okay, these are over X days aged in these categories” so that you give a worklist to a particular department, whether that’s payment posting or whatever it might be? They tend to be much better at those types of systems.
They’re much less capable at tactical reporting and analyses. In this sense, we’ll define this as something that’s giving some direction for a group of people, a department, identifying what particular problems are, determining root causes, prioritizing, even solving specific issues, particularly in revenue cycle management.
For instance, which payers are not going to pay us unless we proactively submit records? That would be a question you’d like to know because there’s a good chance a big part of your team is wasting its efforts, slugging away at specific things that are just going to come back to them. Alternatively, they might be sending out claims unnecessarily with additional documentation when it doesn’t need it.
Most systems aren’t capable of this type of analysis. Even getting the data out of the system to be able to do that is often much harder. For example, trying to do denials management analyses can be quite challenging because, in many systems, you don’t even have the correct fields available.
Perhaps it’s mashed up into a note field or something like that’s text, and you’d have to parse out the information to be able to do the analysis. Further, you’d have to call the clearinghouse and get individual records of all those things, pull all of them, then somehow figure out how to analyze all that collectively. Again, that’s not the revenue cycle management system.
What about the highest reporting tier?
The highest tier for the highest level executives, we’re calling it strategic, is almost nonexistent. Many practices, provider groups, and hospital systems really can’t even see simple reporting and analyses and get the answers they want on a lot of the more fundamental questions. So most often, we’ve seen they haven’t had a chance to define what they’d like to know if they could wave a magic wand. It’s frequently so fanciful that you might as well ask them like, “Hey, what’s your favorite color fairy if you could have one?” “It’s not something I had worried about, so I have no idea.”
The problem is that, as an industry, we need to move up that hierarchy. We run into this a lot where we’ve gone into organizations, and we’ve said, “Hey, we’ve got these amazing things we can do in prescriptive analytics and predictive analytics,” and they say, “Wow, that’s cool! That’s amazing!” And we really can’t get the basic reports. We need descriptive information, retroactive descriptive information.
Bring the light back to reporting
Forget even predicting going forward, just like “What is going on? What already happened, and where is it going?” They can’t get that level of information. Therefore, they’re not able to move on to the higher-level stuff. We see they can’t even see trending information year over year or which providers are ordering what. And it may sound astounding that that’s the case. We’re often amazed that it is that way.
Realistically, until we get out of the dark ages on basic reporting and information that’s needed, we won’t be able to hit the higher tactical and strategic kinds of requirements that will make organizations much more efficient and much more profitable.
Tiers of reporting: Key takeaway
Here’s the shameless plug that we rarely do. There are solutions for getting the data and the answers you want. We can help with those types of things. Allow yourself to dream of what you could get and what you could see, and what you could answer. Clear out the basic stuff, get everybody what they need, and then move up in complexity and strategic thinking.