Zotec Analytical Reporting interface

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ZARi mines big data, pulling together historical experience, complex analytics and business intuition

Meaningful stories are transformed from complex algorithms extracted by ZARi

Final ZARi narrative uses data to answer important questions, provide advice and deliver powerful insight in a precise clear narrative

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Zotec Analytical Reporting interface (ZARi)

zotecpartners.com317.705.5050 | sales@zotecpartners.com

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Glossary of TermsYear over year: Year over year (YoY) comparisons examine data for the most recent month relative to the same month prior year.

Trailing three month: Trailing three month (T3M) comparisons examine data for the most recent month relative to the average of previous three months.

Modality: Modality refers to the category of procedures performed (e.g. Computed Tomography).

RVU: An RVU, or Relative Value Unit, is a unit of physician reimbursement set by Medicare. A procedure assigned a higher RVU value will be reimbursed at a higher rate than a procedure assigned a lower RVU value.

RVU per procedure: This ratio divides total RVUs by total number of procedures performed. Shifts in this ratio over time can illustrate a movement toward higher-value or lower-value procedures.

Payments per RVU: This ratio divides total payments received by total RVUs. Shifts in this ratio over time indicate that the practice is collecting more or less money overall for procedures performed, possibly due to a change in payor mix.

Gross collection rate (GCR): This ratio divides total payments received by total charges. Shifts in this ratio over time can indicate fee schedule changes or changes in carrier contracts.

True Self Pay: True self pay refers to patients that do not have insurance or choose to pay for medical services out of pocket.

Charges on Hold: Charges on Hold (COH) represent the number of procedures and associated dollar value that were not processed due to incomplete billing information.

Denial rate: Denial rate refers to the percentage of claims denied by carriers. This ratio divides the total number of denied charges by the total number of charges filed.

Claim Turnaround Time: Claim turnaround time (Claim TAT) is the average number of days carriers take to respond to claims.

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a percentage of total practice procedure volume YoY.PaymentsFrom the same month a year ago, a significant shift in payor mix made a positive impact on payments. Notably, Commercial Payor's share of practice payments increased 10%, while its payments per RVU also rose. This occurred simultaneously with Medicaid claiming a smaller share of practice payments, down 2% but at reduced payments per RVU. In the period, guarantor responsibility for the allowed amount was 18%, decreasing from 20% YoY. The financial class Commercial Payor drove the climb in practice payments per RVU. Its payments per RVU grew from $27.07 to $51.84 versus the same month a year ago. Simultaneously, Commercial Payor's share of practice paid total RVU increased from 83% to 85%, which also contributed to the rise in practice payments per RVU. The location group responsible for the biggest increase in payments was XYZ LOCATION. Paid procedure volume at the location group grew from 17,418 to 18,109. Medicaid offset the upward trend in practice payments. Payments from Medicaid went down 32% (-$14K).

Insurance Denial RateIn October 2014, PRACTICE NAME’sinsurance denial rate was 14%. Commercial Payor drove the decrease in claim denial rate YoY. Its claim denial rate dropped 29% to 13%. Medicaid drove the decrease in claim denial rate T3M. Its claim denial rate decreased 5% to 37%.

Claim Turnaround TimeThe practice's average turnaround was 22 days in October 2014.

Accounts Receivable SummaryThe practice's total AR grew from $7.4M to $12.0M YoY, and AR over 120 increased from $1.7M to

$3.6M during the same period. Commercial Payor drove both of the increases in total AR (+$4.7M) and AR over 120 (+$1.9M). We expect to eventually collect $24.6M, which is 204% of total AR. Commercial Payor was responsible for the largest dollar value of total AR as of October 2014. We expect to eventually collect $20.3M from Commercial Payor, compared to $2.1M from Medicare, $1.3M from Medicaid, and $852K from True Self-pay.

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SUMMARYCharges at PRACTICE NAME totaled $8.9M for the period ending October 2014. From the same month a year ago, practice charges rose 46% (+$2.8M) because of a climb in procedure volume, which increased from 14,371 to 20,711. However, the dip in RVU per procedure from 3.46 to 2.94 during the same period offset the gains in procedure volume. Imaging LOCATION XYZ drove the boost in procedure volume while Fluoroscopy drove the downturn in RVU per procedure.

A practice-wide shift in payor mix had a positive affect on practice payments year over year (YoY).Commercial Payor's total proportion of practice payments increased during the period while Medicaid claimed a smaller proportion of practice payments. Payments totaled $1.8M in October 2014. From the same month a year ago, practice payments grew 18% (+$196K) because of increases in payments per RVU and paid procedure volume. Payments per RVU went up from $27.25 to $49.19 while paid procedure volume rose from 17,418 to 18,109. Commercial Payor drove the increase in payments per RVU, and Magnetic Resonance drove the upswing in paid procedure volume. However, the reduction in practice RVU per procedure from 3.38 to 2.93 during the same period offset the gains in payments per RVU and paid procedure volume.

ChargesLOCATION XYZ’s higher procedure volume drove charges up YoY. During the same period, however, Fluoroscopy's lower RVU per procedure offset those gains. IMAGING LOCATION’s charges went up 44% (+$2.8M) with Fluoroscopy's charges declining 1% (-$5K) in the same period. The location group responsible for the biggest increase in charges was IMAGING LOCATION II. Procedure volume at the location group grew from 4,371 to 20,711.

Because its RVU per procedure was above the practice average RVU per procedure of 3.42, the procedure group Fluoroscopy drove the slight upturn in practice RVU per

procedure despite being flat YoY. Its RVU per procedure was 3.42 YoY. Simultaneously, Fluoroscopy's share of practice procedure volume decreased slightly from 1% to 0%. Computed Tomography also drove the bump in practice procedure volume. Its procedure volume increased from 1,063 to 1,657 YoY. The location group responsible for the biggest increase in Computed Tomography procedure volume was LOCATION XYZ. Computed Tomography's procedure volume at the location group grew from 1,063 to 1,657.

In October 2014, charges on hold (COH) volume as a percentage of total practice procedure volume grew to 10% from the same month a year ago. The XYZ LOCATION drove the hike in COH volume as

(Please see the Glossary of Terms on the last page for location name abbreviation details.)