Weekly billing report
Example family practice, 3 providers
Sample report · illustrative data
- Charges entered
- 412claims
- Claims submitted
- 405accepted by payer
- Payments posted
- $71,318this week
- Denials worked
- 9 of 9same week
- 0-3058%
- 31-6022%
- 61-9011%
- 91-1205%
- 120+4%
Denials this week
| Code | Reason | Claims | Status |
|---|---|---|---|
| CO-16 | Missing information on the claim | 4 claims | Corrected and resubmitted |
| CO-197 | No prior authorization on file | 3 claims | Retro-auth requested, on hold |
| PR-27 | Coverage had ended by the date of service | 2 claims | Eligibility rechecked, patient contacted |
| Total this week | 9 claims | All worked the same week | |
What's stuck and why
- BCBS: 6 claims pending medical records. Records sent Tuesday, follow-up booked for day 10.
- Medicaid MCO: 2 visits retro-termed. Secondary coverage found on one, patient statement on the other.
- Aetna: 3 procedures denied for authorization. Retro-auth filed, peer-to-peer requested if refused.