| % of Expected | Formula: % of Expected = Expected Amount / (Insurance Payment + Patient Responsibility) |
| % of Medicare | Formula: % of Medicare = Medicare Allowed Amount / (Insurance Payment + Patient Responsibility) |
| Account Type | Account type selected in #1 Patient Information in Patients: Registration. Can be used to group customizable chart types (for example, Insurance, Workers' Compensation, Auto). |
| Adjustment | Amount that was adjusted from the insurance company (for example, contractual adjustment). |
| AR Age by Created Date | Age in days by the created date (for example, 35). |
| AR Age by Service Date | Age in days by the date of service (for example, 33). |
| AR Aging by Created Date | Aging category by the created date (for example, 31-60). |
| AR Aging by Service Date | Aging category by the date of service (for example, 31-60). |
| AR Type | Identifies the balance as the insurance or patient responsibility. If patient aging date is present, the AR Type shows Patient; else, Insurance. |
| Balance-changing transaction | Includes charges, insurance payments, patient payments, adjustments, and write-offs. Represents the change in AR. |
| Billing Provider | Billing provider selected in Charge Entry. |
| Calendar Resource | Name of provider or room/equipment. |
| Change in AR | Formula: Change in AR = Charges – Total Payments – Adjustments – Write-offs |
| Charge ID | System-generated ID that groups service lines to the same charge ledger entry. |
| Days to Pay by Created Date | Number of days between the created date and insurance paid date. |
| Days to Pay by Service Date | Number of days between the date of service and insurance paid date. |
| Ending AR | The ending AR amount is pulled from the charge ledger on the night of month end close date selected in Administration: AR Month End Close. Overlapping changes in AR activity is subtracted from the AR reported on the day of the close.
Formula: Ending AR = Starting AR + Change in AR |
| Expected Amount | Expected amount for the matching fee schedule. |
| Insurance Aging Date | Created date of the charge. Used to assign insurance balances to aging buckets. |
| Insurance Paid Date | Check date of the most recent insurance payment applied. |
| Last Billing Date | Last time a transaction was applied to the charge (e.g., payment applied). |
| Medicare Allowed Amount | Medicare allowed amount from the matching fee schedule. Does not require setup in Administration. |
| Net Payments | Formula: Total Payment Amount – Total Refund Amount
Where Total Payment Amount is from the payment (not the charge or the transaction).
Calculated nightly (approximately 11:50 p.m. PT) for the current month and the previous month. Monthly snapshot by Payment Date available in reports with Report Type = Practice Performance and Performance in the Report Name. |
| Net Receipts | Formula: Total Payment Amount – Total Refund Amount
Where Total Payment Amount is from the payment (not the charge or the transaction).
Day-old data in the Monthly Financial Summary. Available via a custom date span. |
| Overlapping Transaction | Activity that has a ledger date dated in the new month before the old month is closed. Subtracted from the ending AR.
Example: Month end close date for May is June 5. Transactions posted from June 1 through June 5 with a ledger date in June are overlapping transactions. |
| Overpayment | Amount categorized as an overpayment. |
| Patient Aging Date | Established when the insurance balance becomes $0.00 and the patient balance becomes greater then $0.00. Used to assign the patient balance to aging buckets. |
| Patient Balance | Amount that is currently outstanding to the patient.
Formula: Patient Balance = Patient Responsibility – Write-offs – Patient Payments |
| Patient Paid Date | Check date of the most recent patient payment applied. |
| Patient Pregnant | Yes appears if the Pregnant check box is selected in Patient Information in Registration. |
| Patient Responsibility | Original amount categorized as the patient’s responsibility (for example, PR-3 adjustment code for copay applied). |
| Payer | Name of the insurance payer. |
| Payer Class | Description of the payer class selected in Insurance Information in Registration (for example, Commercial FFS). |
| Payer Type | Description of the payer type selected in Insurance Information in Registration (for example, Commercial, Medicare, Medicaid). |
| Payer/Secondary Phone Number | Phone number for the insurance address selected in Insurance Information in Registration. |
| Rendering Provider | Rendering provider selected in Charge Entry. |
| Resident Location | Name of the location entered in Patient Information in Registration. |
| Secondary Billed | Indicates that the secondary claim has been created. |
| Servicing Provider | Servicing provider selected in Charge Entry. |
| Starting AR | The starting AR amount is the ending AR amount from the prior month. |
| Total Payments | Sum of all insurance payments and patient payments applied (excludes overpayments when classified separately).
Formula: Total Payments = Applied Insurance Payments + Applied Patient Payments |
| Total RVU | Includes the Work RVU, Practice Expense (PE) RVU, and Malpractice (MP) RVU). Total RVU is adjusted by locality according to the Geographic Practice Cost Index (GPCI) before being multiplied by their current Conversion Factor (CF) (source: CMS). |
| Work RVU | Reflects the time, technical skill and effort, mental effort and judgment, and stress associated with providing a service (source: CMS). |
| Visit | Unique date of service (DOS) per service line per patient. |
| Write-off | Categorization of increasing or decreasing the patient balance (for example, bad debt). The patient balance increase if the write-off is reversed. |
