Payments Reports
Payments reports can be used to view information about payments received as well as missed copays, adjustments, and denials. Some of these reports are also pulled into other valuable reports such as the Key Indicators reports.
Payments reports generate payment data depending on the user’s workflow at the time payment(s) were entered and applied. For example:
- Payment amounts applied via the Payment record: When a user creates Payment records with the current default Post Date but applies the payment amount(s) to the service line(s) the following day or later, the Post Date of the Payment record is still used for the payment transaction(s).
- Payment amounts applied via the Claim record: When a user creates Payment records then applies payment amount(s) in the Claim record the following day or later, the Posting Date of that claim action is used for the payment transaction(s) (instead of the Post Date of the associated Payment record).
Navigate to Payments Reports
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Payments Reports and Descriptions
Below are the available payments reports and brief descriptions.
| Report Name | Description |
| Payments Summary | Defaults to Month To Date. Pulls data by the Post Date of the Payment record and provides a summary of payments received. The sum of the payment amounts includes refunds and are grouped by Payer Type (e.g., Insurance, Other, Patient). This report also includes the unapplied amounts of the payment amounts. |
| Payments Detail | Defaults to Month To Date. Pulls data by the Post Date of the Payment record and provides a detailed list of payments. The list includes details (e.g., Payment ID, Batch, Post Date) grouped by Payer Type (e.g., Insurance, Patient) and Payment Method (e.g., Check, Credit Card). This report also includes the unapplied amounts of the payment amounts. |
| Payments Application Summary | Defaults to Month To Date. Pulls data by the Posting Date of the payment transaction(s) and provides a summary of applied payments, grouped by Payment Method (e.g., Check, Credit Card) and provider. This report also includes a summary of the Unapplied Analysis. |
| Unapplied Analysis | Defaults to Month To Date and pulls data by the Posting Date of the payment transaction(s). Provides a breakdown of unapplied balances by beginning, change in, and ending unapplied balances. |
| Adjustments Summary | Defaults to Month To Date and pulls data by the Posting Date of the payment transaction(s). Provides a summary of adjustments grouped by provider and adjustment code description. |
| Adjustments Detail | Defaults to Month To Date. Pulls data by the Posting Date of the payment transaction(s) and provides a detailed list of adjustments. The list includes details (e.g., Procedure, Patient Name, Location) grouped by provider. |
| Denials Detail | Defaults to Month To Date. Pulls data by the Post Date of the Payment record and provides a detailed list of denials. The list includes details (e.g., Denial Reason, Procedure, Provider) grouped by the adjustment code description. |
| Payment Receipt | Pulls data by the Post Date of the Payment record and provides a receipt for the specified payment. |
| Contract Management Summary | Defaults to Previous Month. Pulls data by the Posting Date of the payment transaction(s) and provides a list of the average payment received from primary payers for procedures compared to the average and expected allowed amounts. |
| Contract Management Detail | Defaults to Month To Date and pulls data by the Posting Date of the payment transaction(s). Provides a list of payments received from primary payers compared to the actual and expected allowed amounts. The list includes details (e.g., Patient Name, Provider, Unit Charge) grouped by procedure. |
| Payer Mix Summary | Defaults to Month To Date and pulls data by the Post Date of the Payment and Encounter records. Grouped by provider and provides a breakdown of payers by number of patients, encounters, procedures, charges, and receipts. |
| Denials Summary | Defaults to Month To Date and pulls data by the Post Date of the Payment record. Provides a summary of denials grouped by the adjustment code description. |
| Payment by Procedure | Defaults to Month To Date and pulls data by the Posting Date of the Settled transaction. Provides the average reimbursement grouped by Revenue Category (e.g., Medicine, Radiology, Surgery) and procedure. |
| Missed Copays | Defaults to Today and pulls data by the Post Date of the Encounter record. Provides a list of encounters where a copay amount balance was transferred to the patient on an associated Payment record or claim action but no patient payment amount was applied to that balance. |
| Payments Application | Pulls data by the Post Date of the Payment record. Grouped by patient and provides a breakdown of how the specified payment was applied to charges. |