⌚ A/R Report Page (v3) – Athelas

At a Glance

The Accounts Receivable (A/R) Report page allows you to dig into the details of your pending collections from both insurance and patients. Every visualization on this page shares a single set of filters, so drilling down in one graph will update the results in the others, letting you interactively explore the data.

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For detailed information on the A/R Report that you can download from the My Reports page, see this guide.

Summary

What is A/R?

Accounts Receivable (A/R) simply refers to all uncollected charges from all outstanding sources (patients and payers).

A/R is calculated as follows:

Charges - Adjustments - Insurance Paid - Paid PR = A/R

When viewing claims, you will notice they are labeled either ‘Balanced’ or ‘Not Balanced’ based on that equation.

All unbalanced claims will show up in the A/R Report.

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Best Practices 1. When reviewing A/R we recommend toggling off charges less than 0-30 days old, as these are still within the standard timeline for a payer decision and shouldn’t be considered delinquent. 2. Although the Athelas Recon Team will proactively attempt to reconcile your A/R charges, your team can speed up the process! Set your filters and download a CSV of Detailed Charges from the A/R Report. Then, check their status in your Payer Portal. Once you know the payer’s decision, you can upload the result from the EOB Creation page. Note: This CSV will also show outstanding charges that have gone through all Insurance payers and have reached the Patient stage. Just be sure to either disregard or filter those out in your CSV reader.

🌐 Core Features

1. Filters & Configuration

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Note: Any filters activated will affect ALL charts on this page.

The first and most important filter is A/R Mode. This defines what will be considered an A/R charge throughout the dashboard, and has the following options:

Insurance Charges (Payers)

Appointment Charges (PR)

Miscellaneous Charges (PR)

Self-Pay Charges (PR)

If you want to see Insurance Charges, the filters for Payer, Facility and Provider will appear (the Age Range filter will always be available). Use these filters to narrow down the list of charges you're examining and determine where your performance gaps are.

You also have the option to switch between showing Outstanding Balance vs. Number of Charges in your visualizations.

If you want to see details for any of the PR charges (Appointments, Miscellaneous, or Self-Pay), then you will only be able to further filter results by Age Range.

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Note that Appointment mode lists items by Date of Service only, while Miscellaneous and Self-Pay are organized by the date when the associated charge was created.

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The Age / Payer filters are unique in that you can modify them by clicking the chart, allowing you to update your filtering on the fly as you explore the data.

2. Visualizations

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Note: all charts have a 'Download CSV' option in case you'd like to export the data and work in a spreadsheet instead of working in Insights.

Insurance A/R Distribution

Here you can see all of your pending charges, grouped by the age of the submission. This allows you to get a sense of how many outstanding charges fall into each of these buckets:

0-30, 31-60, 61-90, 91-120, and 120+ days old

Additionally you can see what percent of all charges for the given time period remain unreconciled. In the example above, for charges between 91-120 days old:

There are 17 pending charges

These represent 2.5% of all charges submitted in that time range.

Which means this time range is 97.5% reconciled.

Clicking on a column in this graph will update your filters and narrow the data shown in the other two charts on this page.

A/R Payer Breakdown

You can also view a list of the top 20 payers with outstanding A/R, or download the full list as a CSV file. If you filtered to one of the charge age buckets in the previous chart, this payer breakdown will show a payer breakdown just for that selected age segment.

Clicking one or more bars on this chart will also filter the other visualizations on the page to the selected payers.

Insurance A/R Charges

Here you can view high level summary statistics for your filtered list of A/R charges, as well as the details of the charges as well. This list is especially useful if your goal is to check charge statuses in a payer portal.

You can also click the Encounter ID in the right-most column to expand a full detailed view of a charge:

And of course if you prefer to work in a spreadsheet, there’s a ‘Download CSV’ option, above the list headings.

Sorting Options

By default, the Detailed Charges list will sort by Latest Date of Submission. However, you can also sort this list by Date of Service or Initial Date of Submission by clicking the corresponding column heading.

Outstanding PR Charges

The Detailed Charges list will change when you look at Appointments, Miscellaneous, or Self-Pay, rather than Insurance.

Under these filters, you will see a simpler list, with the option to view Patient Details under the Action column.

Click ‘Patient Details’ to view their profile and any charges or outstanding balance they may have.

In Conclusion

The A/R report gives you powerful tools to segment and analyze your pending charges, allowing you to explore your data in a flexible and intuitive manner. If your goal is to reconcile outstanding charges, you have the ability to bring up a list of A/R charges to check statuses for, and those statuses can be uploaded into Athelas via the EOB Creation tool.

❓FAQs

What is the difference between this A/R Report page and the A/R report from My Reports?

A/R Report Page on Insights is just a visualization of the A/R. The download on My Reports is more granular and offers more ways to group and filter the data. They report the same data.

Why is this approved and paid claim still showing up as A/R?

This generally occurs when there is a leftover balance requiring review by our manual posting team.

Example scenario

In this example, the primary payer has approved the encounter and paid everything they’re going to pay, leaving a balance of $11.63. If there were a secondary payer, this balance would then be pushed to them by default, but there is not.

Because the patient is the next payer, Athelas has blocked this balance from being pushed to PR. This is to ensure our systems, and potentially staff, can review the charges and be absolutely certain it should be pushed to PR. Otherwise, it will be adjusted accordingly.

If we click into the details of each procedure, we find four adjustments adding up to $11.63, or the remaining balance.

These adjustments have associated CARC and RARC codes that have not yet been established as automatic adjustments or write offs in the rules engine.

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Note that some CARC/RARC codes do automatically get adjusted by global Athelas rules, such as CO45.

If this practice would like to create rules to always automatically adjust balances from COP12 and COP24, they would contact their account manager to create those rules.

Until this encounter is completely balanced (charges - insurance paid - adjustments - PR = 0), its remaining balance will be considered A/R and be reported as such on Insights.

Please note that this is one possible scenario out of many similar kinds of scenarios. Feel free to reach out to your account manager to go over questions about other cases you may be seeing.

📢 Further Assistance

We’re here to help! Please contact your account manager for some hands-on assistance.