At the heart of identifying and solving payer reimbursement problems is data analysis. The NextGen® Practice Management (NextGen PM) system has a powerful reporting engine that can help you analyze data and evaluate your payer reimbursement. As the industry moves toward value-based reimbursement models, this is more important than ever. Here are four quick tips on how you can better analyze your payer performance.

Tip #1: Capitalize on Sub-Groups

You can divide and analyze data in the NextGen PM system by creating sub-groupings for Payers, Providers, Locations, Tasks, Service Items, and Reason Codes.  These sub-groups facilitate comparisons by grouping items together for better comparisons.  For example, you can sub-group physicians and mid-levels to compare provider productivity.  Likewise, you can sub-group clinic locations and facility locations to analyze outstanding account receivables within these location types.

Tip #2: Calculating Net Collections

The Service Item Summary report allows users to calculate Net Collections by Payer, Financial Class, Referring Provider, and/or Rendering Provider.  You can also use the same logic to calculate Net Collections down to the CPT® code level and perform comparisons by Financial Class for each CPT code.

Tip #3: Identifying Highest Volume Codes

The powerful sorting options in the NextGen PM report writer enables users to quickly identify the highest volume codes by number performed, charge amount, and/or payment amount.  This information is critical when negotiating contracts or evaluating payer performance.

Tip #4: Using the System to Calculate Averages

The NextGen® system has the ability to calculate averages, which you can use to gain critical information, such as the average payment per CPT code or the average charge and reimbursement per encounter.

Download the Evaluate Payer Performance presentation to see how you can optimize your practice management reports for better evaluation of payer performance.