To verify that a medical billing company is earning its fee, a practice should receive more than a monthly collections total. The most useful reporting package connects charges, collections, A/R, denials, adjustments, claim activity, and billing performance so the practice can see where revenue is being generated, where it is being delayed, and what the billing company is doing to improve it.
1. A/R Aging Report
The accounts receivable aging report should be one of the first reports you review each month.
It should show outstanding balances by age, such as:
- Current or 0–30 days
- 31–60 days
- 61–90 days
- 91–120 days
- 120+ days
Do not just look at the total A/R balance. Compare the distribution over time.
If total A/R is increasing while older balances continue accumulating, the practice should ask why. If aged A/R is declining and previously unresolved accounts are being worked, that provides more useful evidence of billing performance.
For practices that need more focused recovery work, A/R management services can also be evaluated based on aging, follow-up activity, payer responses, and recovered balances.
2. Charges, Payments, and Adjustments Report
This report helps connect the services your practice provides with the money actually recorded.
At a minimum, review:
Charges → contractual adjustments → payments → refunds/recoupments → remaining A/R
This can reveal whether changes in collections are related to patient volume, reimbursement, adjustments, payment timing, or other factors.
A high charge total by itself does not demonstrate strong billing performance. The practice needs to understand what happened to those charges after claims were submitted.
3. Net Collection Rate Report
The net collection rate can help determine how effectively the practice is collecting the amount it was contractually entitled to collect after appropriate contractual adjustments.
The report should clearly explain how the billing company calculates the metric.
Do not accept a percentage without knowing:
- Which period is being measured
- What adjustments are excluded
- Whether refunds and recoupments are reflected
- Whether patient and insurance collections are included
- How old A/R affects the calculation
This prevents a practice from interpreting a favorable-looking percentage without understanding the underlying formula.
4. Denial and Rejection Report
A billing company should be able to show what is being denied, why it is being denied, which payers are responsible, and what happens afterward.
Look for information such as:
- Number and dollar value of rejected claims
- Number and dollar value of denied claims
- Denial reason
- Payer
- Date of denial
- Appeal or correction status
- Amount recovered
- Unresolved balance
This report is especially useful because a billing company can submit a large number of claims while still leaving substantial revenue unresolved.
A strong reporting process should help the practice identify recurring problems rather than simply report that denials occurred.
5. Claim Submission and Clean Claim Reporting
Ask for a report showing claim activity during the reporting period.
Depending on the billing workflow, this may include:
- Claims submitted
- Claims accepted by the clearinghouse
- Claims rejected
- Corrected claims
- Claims awaiting payer adjudication
- Clean-claim or first-pass performance indicators
This helps distinguish a submission problem from a payer processing problem.
For example, if claims are repeatedly rejected because of registration or demographic errors, the practice may need to correct its front-end workflow rather than simply asking the billing company to resubmit more claims.
6. Payment Posting and Deposit Reconciliation
Payment posting reports are important because reported collections should ultimately reconcile with actual financial records.
A useful reconciliation process connects:
ERA/EOB → posted payment → contractual adjustment → patient responsibility → remaining balance
The practice should be able to investigate unexplained differences and confirm that payments are being posted to the correct accounts.
7. Payer Performance Report
A payer-level report can reveal patterns that a practice-wide summary hides.
For each major payer, consider reviewing:
- Amount billed
- Allowed amount
- Amount paid
- Denials
- Rejections
- Average payment turnaround
- Outstanding A/R
- Underpayment trends
For example, if one payer consistently produces delayed payments or unusually high denial activity, that may require a different follow-up strategy.
8. Provider or Location Performance Report
Multi-provider and multi-location practices should not rely solely on one consolidated number.
A useful report can break results down by:
- Provider
- Location
- Specialty
- Payer
- Service type
- Reporting period
This helps practice owners determine whether an overall improvement is actually occurring across the organization or is being driven by only one provider or location.
9. KPI Dashboard
A monthly KPI dashboard can bring the most important measurements together.
Depending on the practice, useful KPIs can include:
| KPI | What It Helps You Understand |
|---|---|
| Net Collection Rate | How effectively collectible revenue is being converted into cash |
| Days in A/R | How quickly outstanding balances are being resolved |
| A/R Over 90 Days | How much revenue is becoming increasingly difficult to collect |
| Denial Rate | How frequently claims are being denied |
| Rejection Rate | How often claims fail before payer adjudication |
| Clean Claim Rate | How effectively claims pass initial submission checks |
| Payment Posting Turnaround | How quickly received payments are reflected in patient accounts |
| Outstanding A/R | Total unresolved receivables |
| Denial Recovery | Revenue recovered from previously denied claims |
The important point is to establish a baseline and compare performance consistently. A single month’s number rarely tells the entire story.
What Reports Prove a Billing Company Is Earning Its Fee?
No single report proves that a vendor is delivering value.
Instead, look for a relationship between billing activity and financial outcomes.
For example:
If your practice pays a percentage of collections, you should be able to see where those collections came from, how much A/R remains unresolved, what happened to denied claims, and whether the overall revenue-cycle performance is improving.
If the vendor charges separately for A/R recovery, you should be able to identify the accounts worked and the collections associated with that work.
If coding is included, coding-related reporting can help identify patterns in documentation, coding changes, and claim issues.
This is why evaluating broader revenue cycle management services should include both financial reporting and operational transparency.
Ask for Trend Reports, Not Just Monthly Snapshots
One of the most common reporting mistakes is reviewing each month’s results independently.
Instead, maintain a rolling comparison of:
Current month → previous month → previous quarter → same period last year
This can reveal whether collections are genuinely improving or whether a single strong month is creating a misleading impression.
For a practice changing billing companies, establish the baseline before the transition. Then compare post-transition results against that baseline.
What Should Be Included in Your Billing Agreement?
Your contract should identify which reports the billing company will provide, how frequently they will be delivered, what data they contain, and whether the practice has access to the underlying billing records.
The practice should retain sufficient visibility to independently reconcile collections and understand its A/R position.
The Medicator’s emphasizes a transparent revenue-cycle approach in which practices can evaluate billing performance using financial and operational data rather than relying solely on a vendor’s verbal summary.
A practice should typically receive A/R aging, charges/payments/adjustments, net collection rate, denial and rejection, claim activity, payment-posting, payer, and KPI reports. The goal is not to collect the largest possible number of reports. It is to have enough reliable data to answer three questions: What was billed? What was collected? What revenue remains unresolved, and why?
