Most monthly billing packs are summaries. Collections for the month, a receivables total, a clean claim percentage, sometimes a chart.
All of it accurate. None of it answers the question an owner actually has, which is whether anything is stuck and who is dealing with it.
That distinction matters more than the length of the pack. A summary describes a period that has closed. A report tells you what to do about the period you are in.
What reports should a billing company give me?
Four things every month: what is currently stuck and where, denials by cause rather than by count, payer performance measured against each payer’s own pattern, and anything approaching a filing deadline. Collections and receivables totals are the starting point rather than the report.
Why the standard pack falls short
Not because anybody is withholding anything. Because the numbers most billing companies report are the numbers their systems produce most easily, and those are aggregates.
An aggregate tells you the size of something. It cannot tell you the location, and the location is the only part that can be acted on.
Collections were down four percent. True, and it says nothing about whether that was payer behaviour, a submission backlog, a posting delay, or fewer visits two months ago. Four different causes, four different responses, one number that covers all of them.
The four things worth asking for
What is stuck, by stage. Claims complete and not yet submitted. Claims submitted and aged past normal for that payer. Denials received and not yet appealed. Remittances received and not yet posted. Each with a count and a dollar figure.
That single view answers the question the summary cannot, because every line has an owner and an action.
Denials by cause, not by count. A denial rate tells you the size. Denials grouped by reason tell you whether you have fifty problems or five problems recurring. Almost always the second, and the grouping is the finding.
Payer performance against each payer’s own pattern. Not a blended average. A payer that normally adjudicates in twelve days and is now running at thirty has changed something, and that change applies to every claim you send them from here. A blended figure hides it until it reaches your bank.
Anything approaching a filing or appeal deadline. These are hard dates that do not move. A monthly list of what is inside thirty days of a limit is the cheapest report on this page and the one most likely to be missing.
What it means when these are not offered
Usually not evasion. Three ordinary explanations come first.
Nobody asked. Most billing relationships settle into a reporting pattern in the first month and nobody revisits it for years.
The views take assembly. Several of the four above compare two things rather than summarising one, which is more work than running a standard report.
Or the billing company genuinely cannot see part of it. A billing company works what reaches it, so anything upstream of submission is outside their view by definition. Documentation, charge creation, and unbilled visits are not theirs to report on and never were.
That last one matters, because it means some of what you need cannot come from them at all.
The half no billing company can report on
Worth being clear about, because it changes what you should expect from the relationship.
A billing company acts on claims that reach it. Everything before that point sits inside your practice: documentation waiting on a signature, encounters waiting on a charge, claims built and never released.
None of that is visible to them, not through neglect but through scope. They cannot report on work that never entered their queue.
Which means a practice can have an excellent billing relationship, receive good reports, and still lose money upstream of everything those reports cover. The two facts are entirely compatible and it is the most common misdiagnosis in the arrangement.
So the four reports above are what to ask your billing company for. The upstream view is yours to build regardless of who bills for you.
Getting the upstream half from your AdvancedMD data
Three comparisons cover it, and all three draw on records already being kept.
Completed appointments against created charges. Surfaces visits delivered and never billed.
Signed documentation against created charges. Separates a missing note from a missing charge, which are different problems with different owners.
Charges posted against claims transmitted. Finds claims complete and unreleased, which is the cheapest delay in a practice because nothing external is involved.
Run monthly, per provider where relevant, those three sit alongside your billing company’s four and together they cover the whole distance from visit to bank. Neither half is sufficient on its own, and most practices have only ever seen one of them.
What this means for you
Take next month’s pack and ask one question of it. If everything in here were true, would I know what to do tomorrow.
If the answer is no, ask for the four. They are reasonable requests, most billing companies can produce them, and the conversation itself tells you something about the relationship.
Then build the upstream three yourself, because nobody else can.
Grab 30 minutes with us. Prep nothing. You will see what your current pack covers and what sits outside it.
Questions people ask
What reports should a billing company give me?
Four things monthly: what is currently stuck and where, denials grouped by cause rather than counted, payer performance against each payer’s own pattern, and anything approaching a filing or appeal deadline. Collections and receivables totals are the starting point rather than the report.
Why does my billing report not tell me anything useful?
Because most packs report aggregates, and an aggregate tells you the size of something rather than the location. Collections down four percent could be payer behaviour, a submission backlog, a posting delay, or fewer visits two months ago.
What does it mean if my billing company will not provide these?
Usually that nobody asked, or that the views take assembly because they compare two things rather than summarising one. Sometimes it means the data genuinely sits outside their scope, which is a different answer worth hearing clearly.
Can a billing company report on unbilled work?
No. They act on claims that reach them, so documentation waiting on a signature and encounters that never became charges are outside their view by definition. That half is yours to build regardless of who bills for you.
What should I build myself?
Three comparisons. Completed appointments against created charges, signed documentation against created charges, and charges posted against claims transmitted. Together with your billing company’s four, they cover the whole distance from visit to bank.
PracticePath is not affiliated with, endorsed by, or sponsored by AdvancedMD. AdvancedMD is a trademark of AdvancedMD, Inc. All references are for descriptive purposes only.