What we do / Month-end reportINCLUDED
Your month in writing: billed, paid, owed, next
Each month your billing team sends a written report: what was billed and paid, what is still owed and how old it is, every write-off with its reason, and what we need from you, with an owner for every open item.
The client dashboard is planned. See the sample dashboard
Who does what
Who does what for the report
Software, checked by your billing team
Software
- Assembles the month's numbers for your report.
Your billing team
Your billing team
- Writes the report: what changed, what is open and who owns each item.
- Answers your questions about the report.
You
You
- Read the report and make the decisions it lists.
Month-end report · August 2026
Sample clinic: August billing
Sample view with synthetic data. The client dashboard is planned; this shows what it will track.
Summary
We billed 439 visits in August (3.53 units per visit), worth $47,282.26 in expected payments, and posted $44,958.63. Open A/R ended the month at $48,491.62, or 32.7 days of expected revenue, against $47,773.91 and 31.9 days at the end of July. Payers denied 31 claims (7.8% of the 396 they decided). The top reasons were coordination of benefits (10), missing authorization (9) and missing information (8). By Aug 31 your billing team had sent corrections or appeals on 27 of them. One new pattern: Commercial PPO B paid 97530 less than it allowed on earlier claims in its Aug 25 payment (9 claims, $72.62 short). We will dispute it this week and check every PPO B payment until it is fixed. You approved write-offs of 19 patient balances ($887.28), posted Sep 1.
| Measure | August | July |
|---|---|---|
| Visits billed | 439 | 437 |
| Units per visit | 3.53 | 3.49 |
| Charges (your fee schedule) | $129,979.00 | $128,030.00 |
| Expected | $47,282.26 | $46,364.90 |
| Expected per visit | $107.70 | $106.10 |
| Collected | $44,958.63 | $46,688.61 |
| Written off | $1,605.92 | $1,608.61 |
| Open A/R at month end | $48,491.62 | $47,773.91 |
| Days in A/R | 32.7 | 31.9 |
| A/R over 90 days | 5.8% ($2,827.33) | 5.6% ($2,682.15) |
| Clean claim rate | 96.7% (414 of 428) | 97.0% (420 of 433) |
| Denial rate | 7.8% (31 of 396) | 5.2% (20 of 386) |
| Paid in full on first decision | 89.9% (356 of 396) | 94.8% (366 of 386) |
| Median days, visit to claim sent | 1 | 1 |
| Median days, visit to insurance payment | 22 | 23 |
| Visits 3 months back: collected / open / written off | May: 96.0% / 3.3% / 0.7% | Apr: 97.3% / 1.6% / 1.2% |
Cohort detail: May, 428 visits, $46,361.70 expected: $44,491.43 collected, $1,551.06 open (all patient balances), $319.21 written off. April, 423 visits, $45,351.80 expected: $44,119.23 collected, $706.49 open, $526.08 written off.
| Paid by | Collected in August | Share |
|---|---|---|
| Medicare Part B | $9,091.54 | 20.2% |
| Medicare Advantage A | $1,994.52 | 4.4% |
| Medicare Advantage B | $1,281.32 | 2.8% |
| Commercial PPO A | $6,735.23 | 15.0% |
| Commercial PPO B | $4,244.28 | 9.4% |
| Commercial HMO C | $2,598.78 | 5.8% |
| Payer E (paper checks) | $4,829.37 | 10.7% |
| Medicare supplement plans | $1,589.68 | 3.5% |
| Patients: copays at the visit | $7,040.00 | 15.7% |
| Patients: after a statement | $5,553.91 | 12.4% |
| Total | $44,958.63 | 100.0% |
| Line | Amount |
|---|---|
| Open A/R, Jul 31 | $47,773.91 |
| + Expected from August visits | $47,282.26 |
| (Charges $129,979.00 minus payer adjustments $82,696.74, which include Medicare sequestration of $205.27) | |
| - Collected in August | $44,958.63 |
| - Written off in August | $1,605.92 |
| (Patient balances approved at the July review, posted Aug 3: 29 balances, 21 patients, $877.10. Denials lost after appeal: 6 claims, $728.82) | |
| = Open A/R, Aug 31 | $48,491.62 |
| Owed by | 0 to 30 days | 31 to 60 | 61 to 90 | 91 to 120 | Over 120 | Total |
|---|---|---|---|---|---|---|
| Medicare Part B | $8,870.45 | $401.57 | $63.45 | $0.00 | $0.00 | $9,335.47 |
| Medicare Advantage | $3,316.56 | $410.34 | $80.98 | $0.00 | $0.00 | $3,807.88 |
| Commercial | $17,489.97 | $2,252.61 | $430.78 | $0.00 | $0.00 | $20,173.36 |
| Payer E | $4,604.86 | $1,693.64 | $164.06 | $0.00 | $0.00 | $6,462.56 |
| Medicare supplement plans | $533.16 | $130.89 | $29.47 | $0.00 | $0.00 | $693.52 |
| Patients | $456.70 | $2,447.56 | $2,287.24 | $1,526.73 | $1,300.60 | $8,018.83 |
| Net A/R, Aug 31 | $35,271.70 | $7,336.61 | $3,055.98 | $1,526.73 | $1,300.60 | $48,491.62 |
| Reason (CARC) | Claims | Amount at stake | Status at Aug 31 |
|---|---|---|---|
| Coordination of benefits (22) | 10 | $800.38 | 9 sent, waiting on payer; 1 being prepared |
| Authorization absent (197) | 9 | $601.88 | 8 sent, waiting on payer; 1 being prepared |
| Missing information (16) | 8 | $727.24 | 6 sent, waiting on payer; 2 being prepared |
| Medical necessity (50) | 3 | $214.30 | 3 sent, waiting on payer |
| Visit limit reached (119) | 1 | $104.11 | 1 sent, waiting on payer |
| Total | 31 | $2,447.91 | 27 sent, 4 being prepared |
Also resolved in August (denials from any month): 18 claims, 12 paid after appeal ($882.13), 6 written off (insurer share $666.03).
| Location | Therapist | Visits | Units per visit | Expected | Expected per visit |
|---|---|---|---|---|---|
| North | PT 1 | 95 | 3.39 | $9,457.73 | $99.56 |
| North | PT 2 | 135 | 3.59 | $14,897.54 | $110.35 |
| North | PTA 1 | 33 | 3.48 | $3,006.30 | $91.10 |
| North | Total | 263 | 3.50 | $27,361.57 | $104.04 |
| South | PT 3 | 118 | 3.58 | $13,640.93 | $115.60 |
| South | PT 4 | 41 | 3.54 | $4,647.08 | $113.34 |
| South | PTA 2 | 17 | 3.47 | $1,632.68 | $96.04 |
| South | Total | 176 | 3.56 | $19,920.69 | $113.19 |
| Clinic | All | 439 | 3.53 | $47,282.26 | $107.70 |
PTA rows show lower expected per visit because Medicare pays PTA-furnished services at 85% (CQ).
| Work | Count | Done by |
|---|---|---|
| Eligibility checks before visits | 457 scheduled visits | Software |
| Claims checked and sent | 428 (3 with KX, 23 with CQ) | Software, checked by your billing team |
| Visits held for your input | 20 (12 authorization, 5 coverage, 2 plan-of-care signature, 1 claim number) | You |
| Rejections fixed and re-sent | 16 | Your billing team |
| Insurance payments posted | 52 payments covering 465 claim payments | Software |
| Appeals and corrected claims sent | 33 | Your billing team |
| Payer follow-ups on claims past 30 days | 38 | Your billing team |
| Patient statements | 70 statements covering 105 balances, $2,913.60 | Software |
| Patient balance calls | 30 patients | Your billing team |
What we needed from you at Aug 31 (all cleared by Sep 3): 3 authorizations (Commercial HMO C: Pt 2123, Pt 2147, Pt 2173) and 1 coverage question (Pt 2178).
Focus for September
- Commercial PPO B and 97530: dispute the Aug 25 underpayment and check each PPO B payment until it pays what it allowed before.
- Payer E: 9 claims over 30 days ($1,341.73, 6 patients) out of 45 open ($6,462.56). Your billing team is calling the payer on each.
- Plans of care: 4 Medicare recertifications come due in September. Your billing team will remind the treating therapist before each date.
Questions: reply to this report. Definitions of every number are on the last page.
Last page
Definitions of every number
- Visits billedVisits that produced a claim.
Count of claims by date of service (1 visit = 1 claim)
Where: Overview, report - Units, units per visitBilled units, timed and untimed.
Sum of units; divided by visits
Where: Overview, report - ChargesYour fee schedule times units.
Sum of line charges
Where: Trend, report - ExpectedWhat payers and patients should pay, based on what each payer allowed.
Allowed amount from the remittance, less Medicare sequestration; for a claim not yet paid, estimated from what that payer allowed before for the same code
Where: Everywhere - Payer adjustmentThe part of charges the payer does not allow (CARC 45), plus Medicare sequestration (CARC 253).
Charges - expected
Where: Report - SequestrationMedicare's 2% payment reduction, taken after the deductible and coinsurance (CARC 253).
Allowed x 80% - Medicare paid
Where: Payments, claim record - CollectedMoney posted in the period.
Insurance + supplement + patient payments posted
Where: Overview, Payments - Written offExpected money no longer pursued, with the reason.
Denials lost after appeal + patient balances you approved
Where: Payments, report
Write-offs above your limit need your approval. - Open A/RExpected money not yet collected, net of credits.
Previous A/R + expected - collected - written off
Where: Overview, A/R - Owed byWho owes the open balance now.
Payer until it decides; then supplement and patient shares move to them
Where: A/R - Aging bucketHow old the open balance is.
Days from date of service to today
Where: A/R - A/R over 90 daysShare of open balances on visits more than 90 days old.
Open on visits over 90 days ÷ net A/R
Where: Overview, A/R - Days in A/RHow many days of work are waiting to be paid.
Open A/R ÷ (expected value of visits in the last 90 days ÷ 90)
Where: Overview, report
We use expected amounts (what payers allowed) for both open A/R and daily revenue. MGMA's figures value A/R at gross charges, so its adjusted-charges figure reads higher than ours; no public benchmark uses exactly our basis. - Clean claim rateClaims accepted on first submission, with no clearinghouse or payer front-end rejection.
Accepted on first submission ÷ claims first submitted in the period
Where: Overview, report - Denial rateClaims denied on the payer's first decision.
Denied on first decision ÷ claims decided in the period
Where: Overview, report - Paid in full on first decisionClaims paid at the expected amount the first time.
Paid in full on first decision ÷ claims decided in the period
Where: Overview, report - UnderpaidPaid less than the payer allowed on earlier claims for the same code.
Amount the payer allowed before for the same code - amount paid, per line
Where: Board, Payments - Median days, visit to claim sentHow fast visits become claims.
Median of (first submission date - date of service)
Where: Overview, report - Median days, visit to insurance paymentHow fast payers pay clean claims.
Median of (payment date - date of service), claims paid in full on first decision
Where: Overview, report - Collected / open / written off on visits 3 months backWhat happened to one month's visits.
Each ÷ expected on that month's visits; the three add to 100%
Where: Overview, report - Needs youItems only your practice can clear.
Count of open asks
Where: Overview, Needs you - Held visitA visit that cannot be billed yet.
Claim waiting on your input
Where: Board, Needs you - Payment receivedOne electronic payment or check from one payer on one day.
Count
Where: Payments - Claim paymentOne claim paid inside a payment.
Count
Where: Payments - Credit balanceMoney a patient or payer paid beyond what is owed.
Negative balance
Where: A/R, Needs you - Plan of care certified throughLast day the physician-certified plan covers.
From the signed plan or recertification
Where: Patients - Visits authorizedVisits the plan approved.
From the authorization on file
Where: Patients - Therapy dollars this yearMedicare-allowed PT and speech dollars since Jan 1.
Running total from the claims we bill
Where: Patients
KX at $2,480 (2026); targeted review can apply above $3,000. Source: CMS, Therapy Services.
What the report contains
The numbers in every report
What each number means, in one line. Collections are shown against your charges and against what payers allowed.
How each number is defined| Number | What it means |
|---|---|
| Collected | Money posted in the month, shown against your charges and against what payers allowed for the same visits. |
| Net collection rate | Money collected on a month's visits, minus refunds, divided by what was expected on those visits (what payers allowed), for visits three months back. |
| Clean claim rate | Claims accepted on first submission, with no clearinghouse or insurance company rejection, divided by claims first sent in the month. Corrected claims are not counted as first submissions. |
| Denial rate | Claims denied on the insurance company's first decision, divided by claims decided in the month, by insurance company and by reason. Denials that only move the balance to the patient are not counted. |
| Accounts receivable (A/R) by age | Money still owed, by insurance company and by patient, grouped 0 to 30, 31 to 60, 61 to 90, 91 to 120 and over 120 days from the visit. |
| A/R over 90 days | Open balances on visits more than 90 days past the date of service, divided by net open A/R, at month end. |
| Days in A/R | Open A/R at month end divided by the average daily expected value of visits in the last 90 days. |
| Days from visit to claim | The median number of days from the visit to the day its claim is first sent. |
| Write-offs | Every write-off with its reason and who approved it. |
| Patient balances | What patients owe after insurance has decided, by age. |
- Every open item has an owner and a date.
Questions
Questions about the month-end report
What was billed, what was paid and adjusted, what is still owed by insurance company and by age, denials by reason, every write-off with its reason and who approved it, and what we need from you.
Every open item has an owner and a date.
Yes, in the month-end report. The client dashboard is planned.
Yes. Every write-off appears in your month-end report with its reason and who approved it.