The RVU Utilization Report lists insurance carriers and, for each carrier, the relevant RVU production and details for the procedures that were posted during a selected date range.
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Why: |
To identify insurance carriers with low coverages (this is done by comparing the charges posted with the practice's RVU fee schedule) |
When: |
Yearly, and as needed |
To generate the report
In DXOne Reporting, select Management, and then double-click RVU Utilization.
The RVU Utilization dialog box appears.
Set up the following options:
Date Range - To filter the report by date, do one of the following:
To include procedures that have dates (based on the Date Type) within a range that you specify, select the Specific Range option. With this option selected, do one of the following:
Enter a date range (in a m/d/yyyy format) in the From and To boxes.
To select a date, do the following for From and To:
Click the corresponding calendar icon to view a month calendar.
Navigate to the correct month using the left and right arrows.
Note: To quickly change the year and month, click the month-year at the top of the calendar, navigate to the correct year using the left and right arrows, and then click the correct month.
Click the correct day.
To include procedures that have dates (based on the Date Type) within a range that is relative to the report date, select the Relative Date Range option. With this option selected, select one of the following relative date ranges from the list:
Current Day Current MTD Current Fiscal YTD Current Calendar YTD |
Previous Day Previous Week Previous Month Previous 3 Months Previous 6 Months Previous Fiscal Year Previous Calendar Year |
Next Day Next Week Next Month Next 3 Months Next 6 Months Next Fiscal Year Next Calendar Year |
Date Type - Select one of the following options:
Entry Date - To include a procedure based on the date that it was created (entered into the database).
Procedure Date - To include a procedures based on the date that was specified for it.
Note: Most of the time, a procedure will have the same entry and procedure date. They will differ only if you backdate the procedure.
Insurance Carrier - To filter the report by the insurance carriers that provide plans that are attached to patients, do one of the following:
To include all insurance carriers, select the All checkbox for both From and To.
To include a specific range of insurance carriers, select the starting insurance carrier (alphabetically by name) of the range for From and the ending insurance carrier of the range for To.
To include a specific insurance carrier, select the same insurance carrier for both From and To.
To include an open-ended range of insurance carriers, select an insurance carrier for either From or To, and then select the All check box for the other option.
To select a specific insurance carrier for From or To, do the following:
Click the corresponding search button
.
The Select Insurance Carriers dialog box appears.
Do one of the following:
To get a list of all insurance carriers, do not enter any search criteria.
To search for insurance carriers by name, group plan name, group plan number, local number, payor ID, and/or address, enter the first character or more of an insurance carrier name, group plan name, group plan number, local number, payor ID, and/or address in the Carrier Name, Group Plan, Group#, Local#, Payor ID, and Address boxes, respectively.
Note: To clear any text that you have entered, click Clear Search.
Click Show Results to view a list of insurance carriers.
Note: To clear the list so you can search again, click Search.
In the list, select an insurance carrier.
Click OK.
Clinic - To filter the report by the clinics that are associated with procedures, do one of the following:
To include all clinics that you are allowed to generate the report for, select the All checkbox.
To include specific clinics, do the following:
Click the search button .
The Select Clinics dialog box appears.
Note: Only the clinics that you are allowed to generate the report for are available.
If the list is long, to search for a clinic by ID and/or title, do the following:
Click Search.
The options for searching appear in the upper list.
Enter the first character or more of a clinic's ID and/or title in the ID and Practice Title boxes, respectively.
Click Show Results to view a list of matching clinics.
Note: To return to viewing the list of all the clinics, click Search, click Clear Search to clear the search criteria that you entered, and then click Show Results.
In the upper list, select one or more clinics.
Note: To select multiple clinics, click a clinic, and then, while pressing the Ctrl key, click the other desired clinics. To select a range of adjacent clinics, click the first clinic of the desired range of clinics, and then, while pressing the Shift key, click the last clinic of the desired range of clinics.
Click Add.
Repeat steps b-d as needed to add other clinics.
Note: To remove a clinic that you added, select that clinic in the lower list, and then click Remove.
Click OK.
Provider/Staff - To filter the report by the providers that are associated with procedures, do one of the following:
To include all providers that you are allowed to generate the report for, select the All checkbox.
To include specific providers, do the following:
Click the search button .
The Select Providers/Staff dialog box appears.
Note: Only the providers and staff that you are allowed to generate the report for are available.
If the list is long, to search for a provider by ID, first name, last name, and/or title, do the following:
Click Search.
The options for searching appear in the upper list.
Enter the first character or more of a provider's ID, first name, last name, and/or title in the ID, First Name, Last Name, and Title boxes, respectively.
Click Show Results to view a list of matching providers and staff members.
Note: To return to viewing the list of all the providers and staff members, click Search, click Clear Search to clear the search criteria that you entered, and then click Show Results.
In the upper list, select one or more providers.
Note: To select multiple providers, click a provider, and then, while pressing the Ctrl key, click the other desired providers. To select a range of adjacent providers, click the first provider of the desired range of providers, and then, while pressing the Shift key, click the last provider of the desired range of providers.
Click Add.
Repeat steps b-d as needed to add other providers.
Note: To remove a provider that you added, select that provider in the lower list, and then click Remove.
Click OK.
Note: A procedure may appear on the report if its rendering provider is one of the specified providers for the report.
Billing Type - To filter the report by the billing types that are associated with patients who have procedures entered in their records, do one of the following:
To include all billing types, select the All checkbox.
To include specific billing types, do the following:
Click the search button .
The Select Billing Type dialog box appears.
If the list is long, to search for a billing type by ID and/or description, do the following:
Click Search.
The options for searching appear in the upper list.
Enter the first character or more of a billing type's ID and/or description in the ID and Description boxes, respectively.
Click Show Results to view a list of matching billing types.
Note: To return to viewing the list of all the billing types, click Search, click Clear Search to clear the search criteria that you entered, and then click Show Results.
In the upper list, select one or more billing types.
Note: To select multiple billing types, click a billing type, and then, while pressing the Ctrl key, click the other desired billing types. To select a range of adjacent billing types, click the first billing type of the desired range of billing types, and then, while pressing the Shift key, click the last billing type of the desired range of billing types.
Click Add.
Repeat steps b-d as needed to add other billing types.
Note: To remove a billing type that you added, select that billing type in the lower list, and then click Remove.
Click OK.
ADA Code - To filter the report by procedure code, do one of the following:
To include all procedure codes, select the All checkbox.
To include specific procedure codes, do the following:
Click the search button .
The Select ADA Codes dialog box appears.
Do one of the following:
To get a list of all procedure codes, do not enter any search criteria.
To search for procedure codes by category, abbreviated description, ADA code, and/or description, enter the first character or more of a procedure code category, abbreviated description, ADA code, and/or ADA description in the Category, User Code, ADA Code, and/or Description boxes, respectively.
Click Show Results to view a list of matching procedure codes.
Note: To clear the search criteria that you entered so you can search again, click Search, and then click Clear Search. Then, repeat steps b-c.
In the upper list, select one or more procedure codes.
Note: To select multiple procedure codes, click a procedure code, and then, while pressing the Ctrl key, click the other desired procedure codes. To select a range of adjacent procedure codes, click the first procedure code of the desired range of procedure codes, and then, while pressing the Shift key, click the last procedure code of the desired range of procedure codes.
Click Add.
Repeat steps b-e as needed to add other procedure codes.
Note: To remove a procedure code that you added, select that procedure code in the lower list, and then click Remove.
Click OK.
RVU Schedule - To select the RVU schedule that you want to view production for, do the following:
Click the search button .
The Select RVU Schedule dialog box appears.
To search for an RVU schedule, do the following:
Click Search.
The options for searching appear.
Enter the first character or more of an RVU schedule ID and/or name in the RVU Schedule ID and/or RVU Schedule Name boxes, respectively
Click Show Results to view a list of matching RVU schedules.
Note: To return to viewing the list of all the RVU schedules, click Search, click Clear Search to clear the search criteria that you entered, and then click Show Results.
In the list, select an RVU schedule.
Click OK.
Patient Tag - Do one of the following:
To not filter the report by a patient tag, clear the Run By Patient Tag checkbox.
To filter the report by the tags that are assigned to patients, select the Run By Patient Tag checkbox. With this checkbox selected, the options to filter the report by tag are available. Do one of the following:
To include procedures for patients with any patient tag, select the All checkbox.
To include procedures for patients with specific tags, do the following:
Click the search button .
The Patient Tag Selection dialog box appears.
If the list is long, to search for a patient tag, do the following:
Click Search.
The options for searching appear in the upper list.
Enter the first character or more of a patient tag name in the Tag Name box.
Click Show Results to view a list of matching patient tags.
Note: To return to viewing the list of all the patient tags, click Search, click Clear Search to clear the search criteria that you entered, and then click Show Results.
In the upper list, select one or more patient tags.
Note: To select multiple patient tags, click a patient tag, and then, while pressing the Ctrl key, click the other desired patient tags. To select a range of adjacent patient tags, click the first patient tag of the desired range of patient tags, and then, while pressing the Shift key, click the last patient tag of the desired range of patient tags.
Click Add.
Repeat steps b-d as needed to add other patient tags.
Note: To remove a patient tag that you added, select that patient tag in the lower list, and then click Remove.
Click OK.
Include - Select one of the following options:
All Procedures - To include any procedure.
Only Procedures in Coverage Table - To only include procedures that appear in coverage tables.
Compare Fee Schedule With - Select one of the following options:
Transaction Amount - To compare RVU fees to procedure fees.
Co-Pay From Coverage Table - To compare RVU fees to co-pays in coverage tables.
Other Options - Select or clear the following checkboxes as needed:
New Page For Each Plan - With this checkbox selected, each insurance plan starts on a new page. With this checkbox clear, an insurance plan can start anywhere on a page.
Group By Clinic - With this check box selected, insurance plans are grouped by the rendering clinics of procedures. With this checkbox clear, the insurance plans are not grouped.
Insurance Plan Totals Only - With this checkbox selected, only totals for a plan appear. With this check box clear, procedures and totals for a plan appear.
Click Save as Default to save the current settings for the next time you run the report.
Click Clear Defaults to revert the dialog box options to the original defaults.
Click Schedule to schedule a report job.
Click OK to preview the report.
Important information this report provides
Insurance Carriers - The report is divided by insurance carrier. For each carrier, the name, group plan name and number, and phone number appear.
Procedures - The procedures posted in Ledger for patients with the displayed insurance carrier. For each procedure, the following appear:
Fee - The RVU fee that would have been associated with the procedure if the RVU fee from the RVU schedule that you selected (when setting up the report options) had been used.
RVU - The RVU fee that is associated with the procedure.
Insurance Carrier Totals - For each carrier, the total fees, co-pays, (Fee - RVU), office visits, and patients seen appear. The following is an explanation of the insurance carrier’s Fee and CoPay totals:
Fee - The RVU fee that would have been associated with each procedure if the RVU fee from the RVU schedule that you selected (when setting up the report options) had been used.
CoPay - The RVU fee that is associated with a procedure.
Grand Totals - The Grand Totals section displays the following information:
Fee - The total RVU fees that would have been associated with each procedure if the RVU fee from the RVU schedule that you selected (when setting up the report options) had been used.
Co-Pay - The total RVU fees that are associated with procedures.
(Fee - RVU) - The total RVU revenue that would have been gained or lost if the RVU fee schedule that you selected (when setting up the report options) had been used for the posted procedures. A positive number indicates that the practice would have gained RVU revenue. A negative number indicates that the practice would have lost RVU revenue.
Total Office Visits - The total number of office visits (multiple procedures that were performed on a patient on the same date count as one office visit).
Total Patients Seen - The total number of patients on the report.
