Reporting Tools - Financial reports - insurance vs. patient payments
Estimated Reading Time: 2 MinutesOverview
There has been an increase in requests asking for assistance in determining cash vs insurance patients payments in TDO. While TDO can show you total insurance payments and total patient payments, patient payments will include insurance patients paying their copays and deductibles as well as cash pay patients. Here is a summary on how to collect that data.
Detailed Instructions
You will be required to complete the percentage calculations yourself, but the numbers can be obtained by using the Breakdown Snapshot and the Snapshot (if your office participates with Medicare/Medicaid) or by using Reporting Tools > Financial > Reports by Date > Any Dates.
The one thing to keep in mind here is that the non insurance payments are patient payments but may not be "cash pay" patients. Meaning some of the payments that are patient payments will be from copays paid by the patient so technically they are an insured patient but the balance was paid by the patient.
For offices that do NOT participate with Medicare/Medicaid:
Reporting Tools > Financial > Reports by Date > Any Dates:
On the very first page, at the top there is a summary of payments broken down by type and then a total of insurance payments and then total receipts and adjusted receipts.
The calculation is Insurance Receipts/Total Receipts*100 (so with the above example $1070 divided by $4000 is .2675 or 26.75%)
For offices that do participate with Medicare/Medicaid
The insurance company/companies must be clearly listed as such already or there is no way to separate that out from other insurance payments.
Reporting Tools > Financial > Breakdown Snapshot - Set the date range
Total insurance payments were $1070
Medicare payments were $150
All other insurance payments then were $920
Reporting Tools > Financial > Snapshot - Set date range
Percentage of Medicare payments is $150/$4000 which is .0375 or 3.75%
Percentage of all other insurance payments is $920/$4000 which is .23 or 23%