New standard report: RCM Event Analysis

This report provides claim level detail of the first 4 revenue cycle management events for each insurance payment, receipt of CARCS/RARCS, application of follow up notes/actions, as well as the current information for each item.

Accessing the report RCM Event Analysis

Note: You will need ReportsAnalysis permissions to access this report

Search for "RCM" or locate the report within the Analysis green reporting tile

Event Categories and use cases

Below will provide a brief description of each RCM event category and possible use cases.

Filed Charges

These columns represent the actual dates of claim submission along with the total charges that were submitted on the claim. They can be useful to identify corrected claim refiling trends (if charge amounts change = corrections were made to coding).

Note: Current claim charges shows the actual charge balance on the account as of when the report is run. If this is different from the filed charges columns it indicates adjustments to charges were made after filing.

Payment information

A firstpaid, secondpaid, thirdpaid, fourthpaid, and currentpaid set of payment information exists within this report. For each section the actual payment date (batch date aka bank deposit date) is shown along with the allowable, allowable percentage, patient coinsurance/deductible, and patient charges (total of copay, coins, deductible).

Note: Patient payments and insurance payments with an allowable = $0.00 are removed from this report in order more accurately show changes in insurance allowables over time.

A delta field is provided and is calculated as follows

alloweddelta_1 = secondallowed - firstallowed

alloweddelta_2 = thirdallowed - secondallowed

alloweddelta_3 = fourthallowed - thirdallowed

AllowedDelta_Current = The current allowed amount for the claim - the firstallowed amount. This should represent the total delta change at current.

As an example below, if you see an allowed delta < 0 it indicates the insurance company reduced its allowable between its first and second payments. Allowed delta > 0 indicates an increase in allowed.

Follow up status and notations

The "fup" status section will show you the first four biller actions taken on the account along with the current action.

AllFollowupStatuses is a field containing an aggregated list of ALL actions (including those beyond action 4) for the claim. This field is very useful for filtering to just accounts that have ever had a specific follow up action.

For example, you can use the Text Filters --> Contains functionality to search for any follow up statuses containing the word "negotiation" (you would specify your custom followup status verbiage)

The filter then shows all claims that have ever had a followup status with the word negotiation in it.

GoRev Support Team

If you have any questions, concerns, or problems regarding this GoRev Tutorial, please contact the GoRev Support Team by submitting an IT Support Ticket, by phone at 1-(317)-794-3900, and/or by email at ask@gorev.com.

Note: If possible, always submit an IT Support Ticket detailing any problem that you are experiencing within GoRev. This will give GoRev Support Agents access to additional information that will help expedite the resolution of your issue. If you are unsure how to submit an IT Support Ticket in GoRev, please see theIT Support Ticket Creation for assistance.