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REVENUE & PROFITABILITY User Guide

Version 1.1 – 9/24/2015

TABLE OF CONTENTS ABOUT THIS DOCUMENT ....................................................................................................................................... 3

REPORT CODE DEFINITIONS .............................................................................................................................................. 3

REVENUE & PROFITABILITY OVERVIEW .................................................................................................................. 3

WHERE AM I MOST PROFITABLE? ....................................................................................................................................... 3

WHERE AM I LOSING MONEY AND WHY? ............................................................................................................................. 4

HOW CAN I UNDERSTAND OUR REVENUE AT A DEEPER LEVEL? .................................................................................................. 4

HOW IS OUR REVENUE TRENDING IN THE CONTEXT OF THE LAST 12 MONTHS? ............................................................................ 5

WHY DIDN’T WE COLLECT OUR MONEY? .............................................................................................................................. 5

HOW MUCH PENDING REVENUE AND UNBILLED REVENUE DO WE HAVE? .................................................................................. 6

HOW MUCH REVENUE IS ON HOLD AND WHY? ...................................................................................................................... 7

ADDITIONAL REPORT GROUPS ........................................................................................................................................... 7

CPR+ ANALYTICS DASHBOARDS – MANAGE ........................................................................................................... 7

CPR+ ANALYTICS – COMPANY SETUP ................................................................................................................................. 8

DASHBOARD – EXECUTIVE SUMMARY ................................................................................................................................. 8

Scorecard – Cash vs. Goal ..................................................................................................................................... 8

Scorecard – DSO ................................................................................................................................................... 9

Scorecard – Current AR ......................................................................................................................................... 9

Scorecard – Bad Debt Reserve .............................................................................................................................. 9

Scorecard – Net Revenue ...................................................................................................................................... 9

Scorecard – Pending Revenue ............................................................................................................................... 9

Scorecard – Unbilled Revenue .............................................................................................................................. 9

Scorecard – Posted Cash ..................................................................................................................................... 10

Scorecard – Posted Adjustments ........................................................................................................................ 10

Scorecard – Ready to Bill Tickets ........................................................................................................................ 10

Trending Graph – Revenue and Cash Trending – Last 12 Months to Date ......................................................... 10

Adjustments by Adjustment Type ....................................................................................................................... 10

Unbilled Revenue by Status ................................................................................................................................ 10

Pie chart – Cash Posted (Top 5 Payer Types) ...................................................................................................... 10

Pie Chart - Cash Posted Aging ............................................................................................................................ 10

Pie Chart - AR (Top 5 Payer Types) ..................................................................................................................... 11

Pie Chart - AR Aging............................................................................................................................................ 11

DASHBOARD – REVENUE DETAIL BY PAYOR ........................................................................................................................ 11

Scorecard – Total Net Revenue ........................................................................................................................... 11

Scorecard – Total Unique Patients ...................................................................................................................... 11

Scorecard – Net Revenue by Therapy ................................................................................................................. 12

Filter – Payers ..................................................................................................................................................... 12

Filter – Core Selection ......................................................................................................................................... 12


Pie Chart – Net Revenue by Line of Business ...................................................................................................... 12

Trending Graph – 12 Month Net Revenue vs. Cash ............................................................................................ 12

Trending Graph – 12 Month Patient / Invoices Counts....................................................................................... 12

DASHBOARD – REVENUE DETAIL BY PHYSICIAN ................................................................................................................... 13

Scorecard – Net Revenue .................................................................................................................................... 13


Filter – Physician on Claim .................................................................................................................................. 13


Pie chart – Net Revenue by Line of Business ....................................................................................................... 14


Trending Graph – 12 Month Patient / Invoice Counts. ....................................................................................... 14

DASHBOARD – REVENUE DETAIL BY STATE ......................................................................................................................... 14

Scorecard – Net Revenue .................................................................................................................................... 15



Filter – Net Revenue by State ............................................................................................................................. 16

Pie Chart – Net Revenue by Line of Business ...................................................................................................... 16


Trending Graph – 12 Month Patient / Invoice Counts ........................................................................................ 16

DASHBOARD – REVENUE MANAGEMENT........................................................................................................................... 16

Gauge - Revenue vs. Goal ................................................................................................................................... 17

Scorecard – Revenue (MTD) ............................................................................................................................... 17

Scorecard – Revenue (LBD) ................................................................................................................................. 17

Scorecard – Unconfirmed Tickets > 2 Days ......................................................................................................... 17

Scorecard – Unbilled Revenue ............................................................................................................................ 18

Scorecard – RTB Tickets ...................................................................................................................................... 18

Scorecard – Pending Revenue ............................................................................................................................. 18

Scorecard – Unexpected Denials ........................................................................................................................ 18

Scorecard - Revenue vs. Goal (T) ........................................................................................................................ 18

Scorecard - Revenue Projection .......................................................................................................................... 18

Scorecard - Average Days to Bills ....................................................................................................................... 18

Scorecard - Tickets < 5 Days of Timely Filling ..................................................................................................... 18

Trending Graph – Revenue and Cash Trending – Last 12 Months to Date ......................................................... 18

Trending Graph – Unbilled History Last 6 Months .............................................................................................. 19

Pie Chart – Revenue Top 10 Payors .................................................................................................................... 19

Pie Chart – Unbilled Revenue by Status .............................................................................................................. 19

CPR+ ANALYTICS CUBE – ANALYZE ....................................................................................................................... 19

CUBE – REVENUE CUBE ................................................................................................................................................. 19

Global Layout – Biller Productivity ...................................................................................................................... 19

Global Layout – Trending Revenue by Therapy .................................................................................................. 19

CUBE – PROFITABILITY CUBE ........................................................................................................................................... 20

Global Layout – Invoices where Cost Equals Zero ............................................................................................... 20

Global Layout – Invoices where the Margin is Less than or Equals to 3% .......................................................... 20

Global Layout – Profitability by Payor Type ........................................................................................................ 20


ABOUT THIS DOCUMENT This User Guide will get you started with the reports, dashboards and cubes that are a part of the Revenue and

Profitability Solution. Rock-Pond groups all of its business intelligence content (reports, dashboards and cubes)

into one of 8 solutions. We recommend a 3 step approach, “DIVE IN, MANAGE AND ANALYZE” to understand

what is available and begin using Rock-Pond products effectively.

1. DIVE IN to the reports – there are many reports in the billing solution, grouped into report groups and a “catch all” report group called other. This document will go through the most commonly used reports in the business solution. Once you understand and master these you will be able to go through the other report groups to find what you need.

2. Review the dashboards to understand how they will help you MANAGE your business. Dashboards provide a high level view of metrics that give you access to critical information at a glance. This document will provide an overview of each metric on the dashboard, why it is there and how you can use it.

3. Review the data groups and global views available in the cubes to help you ANALYZE information at a deeper level.

4. Finally, Appendix A and B to have an understanding of all Solutions and how Rock-Pond can assist you further.

REPORT CODE DEFINITIONS

All reports have the same code but depending on what version of CPR+ you are on (Line Item Financials or Legacy)

will depend on the prefix. Legacy will start with “!c2_” and Line Item Financials will start with “!c3_”. Please make

note of the system you are on to find the correct report.

REVENUE & PROFITABILITY OVERVIEW Increasing revenue and profitability is the number one goal of any company because generating profits is what

allows you to stay in business. Not only is it important to see what was billed, but you need to see where your

revenue is coming from, how it is trending, why you aren’t receiving money, and where you are missing

opportunities. The Revenue & Profitability Solution will allow your CFO to report on key financial indicators that

drive your business and as a result, your revenue and profitability will increase.

ROCK-POND REPORTS – DIVE IN

WHERE AM I MOST PROFITABLE?

1184B – PROFITABILITY ANALYZER

From a financial and profitability perspective, everything is not equal. In order to manage your business, you

must understand the most profitable areas of your company so you can focus on what will be most beneficial.

Our Profitability Analyzer allows you track profitability by grouping your invoices based on a combination of up to

three areas that drive your business such as payer type, payer, and therapy. Follow these quick steps to analyze

your profitability:


Run the 1184b report with the default grouping options for last month to see a high level look at your profitability grouped by payer. Glance through the EXPECTED PROFIT MARGINS to see which payers are most profitable.

Now, toggle your parameters and add therapy as a secondary grouping option and rerun the report. In order to manage your business to drive profitability, you must understand which payer / therapy combinations are “good” business and which ones are not.

Next you can look at your INFORMATION by the grouping options of your choice. If you are a specialty pharmacy, you might want to group the report by NDC to see which drugs you are most profitable on. Or you could run it by referral source to see if they are sending you good business. The possibilities are almost endless.

The report can be validated with the global layout [Rock-Pond] Profitability by Payor Type in the Profitability

Cube or the Profitability report (by Therapy, Payor, or Patient) in CPR+. Make sure the date to base the report off

of (Date of Service or Date Billed), the date range, and the grouping are the same for accurate results.

WHERE AM I LOSING MONEY AND WHY?

1184B – PROFITABILITY ANALYZER

Since generating profits is what allows you to stay in business, you need a comprehensive analysis of your

profitability which shows not only where you are profitable but also where you are losing money. With the

Profitability Analyzer that was run above, you can also zero in on invoices you are losing money on, billing issues,

invoices without any cost associated, etc. so corrective action can be taken. Follow these quick steps to discover

where you are losing money:

Run the Profitability Analyzer for the date range of your choice and use INVOICE THERAPY as the primary grouping option. Choose to only show INVOICES WHERE COST IS GREATER THAN EXPECTED. You will see a summary look of the invoices by therapy that you are losing money on.

Go back to your report parameters and choose to SHOW CLAIM LEVEL DETAIL and rerun the report. You now have a detailed list of the invoices by therapy where the COGS is greater than the expected amount. Click on the invoice number in blue to the left of each patient to drill down on the confirmed delivery tickets for that invoice and identify where you are leaving money on the table.

Now rerun the report with the same parameters except choose to view INVOICES WITH NO COST. This allows you to see where there is an issue with the cost of the service, which may make it seem overly profitable and can skew the overall numbers. You can identify pricing issues in your system that need resolved in order to prevent issues down the road and to more accurately monitor your profitability.

In order to validate this part of the report, you can run the [Rock-Pond] Invoices where Margin is Equal or Less

than 3% global layout and change the filter to show the margin of less than 0%. You can also use one of the

Profitability reports in CPR+ (Therapy, Payor, or Patient), export to Excel, and sort the profit ascending (or filter

on negative profit) to see where you are losing money.

HOW CAN I UNDERSTAND OUR REVENUE AT A DEEPER LEVEL?

1243A – REVENUE ANALYZER WITH AVERAGES

A list of invoices is not enough to fully understand your revenue. You must be able to break down your revenue by

key factors such as the payer type and revenue code or therapy type to truly know your business. Perhaps you

need to answer “Why is the pharmacy busier week after week but revenue is flat?” or “How is the reimbursement


rate change for Drug X going to affect my revenue?”. Our Revenue Analyzer with Averages report generates a

summary report that reveals not only what your revenue is, but will help you analyze it at a deeper level.

Run the 1243a report for last month based using the default grouping options of THERAPY within PAYOR TYPE. Notice that it shows totals for your overall revenue as well as breaking it down for each payor type and for each therapy associated with that payor type. Averages included on the report are the average revenue per claim, average revenue per patient, and average revenue per day. It also shows the total number of invoices, patients, and days.

Rerun the report and add PATIENT NAME as the tertiary grouping option. This will show you which patients are associated to each therapy by payor type.

What business indicators do you use to understand your revenue? Run the report by using up to three of the grouping options that are important to your business, such as payor, referral source, or physician.

This report can be validated by using the global layout [Rock-Pond] Trending Revenue by Therapy. Remove the

therapy field and add in other key indicators to truly turn the layout into an analyzer. It can also be validated with

the Revenue report (by therapy, payor type, or revenue code) in CPR+. Keep in mind that the layout and the

CPR+ report will not give you the average and you will need to manually calculate that.

HOW IS OUR REVENUE TRENDING IN THE CONTEXT OF THE LAST 12 MONTHS?

1151G – 12 MONTH DESCENDING REVENUE ANALYZER

Your biggest opportunities (and risk) are often in the mid to lower tier of your business. Because of this, it is

important to see trends in your revenue for the past 12 months to catch issues before it is too late. Our 12 Month

Descending Revenue Analyzer allows you to select up to three groupings based on the key metrics that drive your

business. See your revenue trends based on where it is coming from, the types of services you are providing, who

is paying for it and more.

See today’s business in the context of the last 12 months by running this analyzer for the last year by therapy. Note the therapies on top which made up the largest portion of your revenue and what the exact percentage of revenue it was.

Stay on top of any decreases in revenue from your physicians by changing the primary grouping to physician and comparing this month’s revenue to previous months. If you notice any significant changes, contact that physician to identify the cause. You can also navigate to the last page to see the total number of invoices and physicians.

Now go see your business trends by where it is coming from and who is paying for it by using referral source, payer type, payer, or a combination of the three grouping options.

This report can be validated by using the [Rock-Pond] Trending Revenue by Therapy global layout or the Revenue

report (by Therapy, Payor Type, or Revenue Code) in CPR+. If you use the revenue report in CPR+, you need to

run it monthly YTD, export the report into Excel and create a descending sorted trending revenue report

manually. To make the validation process easier, group the three reports by therapy type (run the CPR+ revenue

report by therapy).

WHY DIDN’T WE COLLECT OUR MONEY?

1306 – CLAIMS ANALYSIS ANALYZER


Claims analysis is critical. Not only is it important to see what was billed for a time period, it is important to see

what was booked as revenue and what we EXPECT as profit. Probably more importantly is how well we are at

collecting what we expect. If your business was highly profitable but lousy at collection, you would quickly be out

of business. It is imperative that you be both profitable and good at collecting cash for your business to thrive.

Our Claims Analyzer is an excellent way to analyze the status of your claims in order to see this INFORMATION. It

shows expected revenue for a period of time then identifies cash, adjustments, and the balance remaining.

Run report 1306 for last quarter. Select PAYOR TYPE as the primary grouping option and THERAPY as the secondary. The report will show a summary look at your expected revenue, credit rebills, cost, payments, and adjustments for the claims for each therapy grouped within payer type. Use this to see if a specific payer type of therapy is hard to collect on.

For a detailed look into exactly what has happened to your claims, rerun the report and choose YES to show claim level detail. Find a claim where payments and/or adjustments have been made. Click on the invoice number for that claim to see reimbursement data including line item, payment, and adjustment detail.

Now change the primary grouping to BILLED MONTH and the secondary to THERAPY. Choose YES to show detail and select SHOW INVOICES WITH NO PAYMENTS OR ADJUSTMENTS in the parameters. Quickly scan through older claims to see where no payments or adjustments have been made and determine why you haven’t collected your money.

In order to validate this, you will need to spot check claim by claim in CPR+ system. The % of payments,

adjustments, and balance can be verified manually by dividing the data by the expected amount.

HOW MUCH PENDING REVENUE AND UNBILLED REVENUE DO WE HAVE?

1348 – COMBINED UNBILLED EXTRACT REPORT

In order to determine your true revenue numbers, you need to know not only what your billed revenue numbers

are, but also, what is unbilled. Our Combined Unbilled Extract report shows you the pending revenue and

unbilled revenue in your system as of right now. Since it is an extract report, you can easily export it to Excel to

sort, filter, and manipulate the DATA in order to get the INFORMATION you need.

Run report 1348 in your Information Center using the default parameters. Once the report has run, it will look like a mess since it is an extract report. Therefore, you should go to the menu bar at the top and choose to EXPORT TO EXCEL (DATA ONLY). The export will show you: key patient information, the name and phone number for the primary patient physician, payer, payer type, therapy, delivery ticket info, date of service, and expected amounts.

Try sorting the extract by PAYER to group your unbilled revenue by payer. Then you can filter the sheet to only show one specific payer. This will be useful as a resource when determining why you aren’t billing to a specific payer.

You may want to look at the unbilled information for only one or more therapies. To reduce time spent manipulating DATA, the report gives you the option to run it for only specific therapy types. So go back to the report and change the parameters to only show one therapy. For example, enter TPN in the field to enter therapies. If you have defined core therapies, you can enter those here also by separating them by commas.

As mentioned above, the 1348 – Combined Unbilled Extract report shows you the pending revenue and unbilled

revenue. Note the last column record indicator to determine what element you are analyzing. “RTB” is unbilled,


and “Electronic” is pending revenue. In order to validate these, you need put a filter on the record indicator and

look at one element at a time.

Electronic or pending revenue – Use the Pending Revenue report in CPR+ that can be found in Billing reports-Revenue reports-Unbilled reports-Pending revenue report. Make sure you run the report by Date Billed and use the same date range.

RTB or Unbilled – Use the [Rock-Pond] Unbilled by Ready to Bill Status global layout to validate this part of the report.

HOW MUCH REVENUE IS ON HOLD AND WHY?

1243B – ON HOLD REVENUE ANALYZER

In addition to knowing your billed revenue and unbilled revenue, you must also be able to see what revenue is on

hold. In CPR+, an invoice has a status which may be on hold for a various number of reasons such as waiting for

an authorization or CMN. Our On Hold Revenue Analyzer shows any revenue that is on hold in your system for a

period of time defined by you. Start analyzing your on hold revenue by following these steps:

Run 1243b for the date range of your choice. Select INVOICE HOLD STATUS as the primary grouping and PAYOR as the secondary grouping. Choose NO to not show claim level detail. You will see a nice summary report of how much on hold revenue you have for each payer grouped by the hold status associated with that ticket.

You may want to contact one payer at a time to discuss all patients with tickets on hold. To do this, run the report with PAYOR as the primary grouping option and INVOICE HOLD STATUS as the secondary. In order to see which patients are associated with these payers, change the parameters to show claim level detail by selecting YES in that field and rerunning the report.

Try looking at your on hold revenue by other key business indicators by selecting up to three grouping options of your choice, such as therapy, payer type, or patient name

The On Hold Revenue Analyzer can be validated with the On Hold Revenue report in CPR+. Make sure the date range of the two reports match for accurate results.

ADDITIONAL REPORT GROUPS

The Revenue & Profitability Solution contains the following report groups. To see the reports in each of these

groups, view all reports in the Rock-Pond Information Center grouped by Solution + Report Group

Financial Reporting – The reports in this report group allows you to see each financial area at a summary level as well as a detail level. That way, you can then make decisions that will improve performance and productivity as well as prevent problems.

Month End – The reports in this report group is mainly used at the end of the month.

CPR+ ANALYTICS DASHBOARDS – MANAGE CPR+ Analytics enables you to see your business at the “big-picture level using dashboards and analyze at the

deepest level using cubes. The following is an overview of the dashboards and cubes provided with the Revenue

and Profitability Solution.


CPR+ ANALYTICS – COMPANY SETUP

The following settings are required for this dashboard to function accurately:

Monthly Targets

Cash Target for current month

Revenue Target for current month

Settings

How many days of revenue do you use to calculate DSO?

What date do you age AR against?

Business Rules

Bad Debt Reserves set for all buckets

Non-Business Days set

Data Extensions

Therapy Types: Core Therapy and Line of Business

Adjustment Type set

DASHBOARD – EXECUTIVE SUMMARY

The Executive Summary Big Picture Dashboard gives top level employees insight into the key financial pieces of their business. With this dashboard, see snapshots of key business indicators such as revenue, DSO, A/R, adjustments, cash and more. Then business trends and determine if goals are being met.

SCORECARD – CASH VS. GOAL

Identify the Cash target values for each CPR+ site and enter it into the monthly target for the current month at

minimum. Then use this element to monitor if cash goals are being met throughout the month. The percentage

is based on cash posted divided by the monthly goal for select sites plus cash that is posted on “site not assigned”.


Run the 1245az – Payment Aging or 1072z – Cash Posting Journal for the current month to date and compare the

amount with the goal set in the Company Setup options.

SCORECARD – DSO

Our DSO formula is a simple calculation of the overall A/R balance divided by the average revenue per day for a

period. The number of days of revenue used to calculate DSO is specific to each organization and can be entered

into the Setting option in the company setup that says: “How many days of revenue do you use to calculate DSO?”

To validate the DSO scorecard, run the 1357 – DSO Analyzer to calculate your DSO as of today’s date. Enter the

same number of days in the Average Daily Sales parameter option of the report as the amount entered in the

Settings option of your Company Setup. Combine selected sites to see your DSO for the entire organization, then

separate by site to validate numbers for each site.

SCORECARD – CURRENT AR

The Current A/R element allows users to quickly see the total amount of A/R for the organization. The amount represented is as of the last A/R feed, which defaults to nightly. In the Settings tab of the Company Setup, determine what type of date to age the A/R against. To validate the current A/R, run the 1234z – AR Aging Analyzer and combine sites initially to see your A/R for all CPR+ sites. The default parameters can be used.

SCORECARD – BAD DEBT RESERVE

Bad Debt Reserve is calculated in Analytics by reserving a percentage of the overall A/R balance from each aging

bucket identified. The Bad Debt Reserve aging buckets and percentages are added in the Business Rules of the

Company Setup. Note the date value that A/R is aged by where asked: “What date do you age AR against?” The

bad debt aging buckets are based on the same value. To validate this element, run the 1389 – Bad Debt Reserve

report and make sure the aging buckets and their % you set up in Company Setup corresponding with the

parameter of the report.

SCORECARD – NET REVENUE

The Revenue element is the total expected revenue for the month to date. This number takes into account any

revenue adjustments based on the Adjustment Categories set up in the Data Extensions of the Company Setup. To

validate this scorecard, run 1243a – Revenue Analyzer for the month to date. Since this element takes into

account Revenue Adjustments, also run the 1245az – Adjustments Aging Analyzer by Billed Month and

Adjustment Type to identify any revenue adjustments.

SCORECARD – PENDING REVENUE

The Pending Revenue scorecard shows the expected revenue on invoices that have been created but are pending.

Run the 1243f – Pending Revenue Analyzer to validate this scorecard and dive deeper into analyzing pending

revenue. The report will ask for a date range and an “all time” date range should be entered to include all of the

pending revenue.

SCORECARD – UNBILLED REVENUE

The Unbilled Revenue scorecard is the current total of the expected amount on billable items on delivery tickets

that are confirmed but have not been assigned to an invoice. Run the 1025j – Unbilled Aging Analyzer or the

[Rock-Pond] Unbilled by Ready to Bill Status global layout to validate this scorecard.


SCORECARD – POSTED CASH

The Posted Cash scorecard is the total amount of cash that has been posted month to date. Run the 1245az –

Payment Aging or 1097z – Cash Posting Journal for the current month to validate this. Drill down and see the

breakdown for each site or for ALL SITES combined.

SCORECARD – POSTED ADJUSTMENTS

The Posted Adjustments scorecard gives the total amount of adjustments that have been made month to date.

Run the 1245bz – Adjustment Aging Analyzer for the current month and see the breakdown for each site or for

ALL SITES combined to validate this element.

SCORECARD – READY TO BILL TICKETS

The Ready to Bill Tickets scorecard is the number of tickets that are confirmed but not associated with an invoice

and are in a status of “Ready to Bill.” Use the ticket cube to validate this element.

TRENDING GRAPH – REVENUE AND CASH TRENDING – LAST 12 MONTHS TO DATE

The 12 Month Net Revenue versus Cash trending element shows the last 12 months of revenue versus the cash

posted based on the ending date of the time period. Net revenue is the expected revenue minus and revenue

adjustments entered. In order to validate this element, run two reports, 1245az – Payment Aging or 1072z – Cash

Posting Journal and 1243a – Revenue Analyzer for the same time period and group by Posted Month and Billed

Month respectively.

ADJUSTMENTS BY ADJUSTMENT TYPE

This element shows why A/R is being written off. It provides a month-to-date breakdown of adjustments made

based on the Adjustment Type. Use the company setup to create Adjustment Categories and to identify if the

adjustment types impact revenue. To validate the element, run the 1245bz – Adjustments Aging Analyzer using

the month to date range and make Adjustment Type the primary grouping option. You can also use the

Adjustment Trending by Adjustment Type global layout to validate the element.

UNBILLED REVENUE BY STATUS

The Unbilled Revenue by Status list gives a breakdown of unbilled revenue grouped by the ready to bill status. To

validate the element, run the 1025j – Unbilled Aging Analyzer or the Unbilled by Ready to Bill status global layout.

PIE CHART – CASH POSTED (TOP 5 PAYER TYPES)

The Cash Posted Cash pie chart shows a percentage breakdown of the top 5 payer types as of today for the

current month. Scorecard is the total amount of cash that has been posted month to date. Run the 1245az –

Payment Aging for current month and make PAYOR TYPE the primary grouping option. The report is set up in

descending balance for an easier auditing process. To dive in even deeper, try adding PAYOR as a secondary

group. The Cash Cube can also be used to validate this pie chart.

PIE CHART - CASH POSTED AGING

The Cash Posted Aging pie chart allows users to determine if old A/R or current A/R is being collected. The aging is based on how A/R is aged in the Settings of the Company Setup and aging buckets are the same as set up for bad debt buckets. Use the 1245az – Payment Aging Analyzer to validate the Cash Posted Aging. Set the aging buckets corresponding to the Company Setting.


PIE CHART - AR (TOP 5 PAYER TYPES)

The A/R for Top 5 Payor Types element shows a percentage breakdown of the top 5 payor types for A/R as of

today. To validate it, run the 1234z – AR Aging Analyzer report as of today. Make PAYOR TYPE the primary

grouping option. The report is set up in descending balance for an easier auditing process.

PIE CHART - AR AGING

This element is used to quickly determine the age of outstanding A/R. The A/R is divided into aging buckets as set up in the Company Setup. The aging buckets are based on the date identified in the Settings. To validate the A/R Aging, run the 1234z – AR Aging Analyzer report as of today. Make sure the aging buckets correlate with those set up in the Company Setup.

DASHBOARD – REVENUE DETAIL BY PAYOR

The Revenue Detail by Payer drill down dashboard allows providers to see where their revenue is coming from by showing revenue distribution by payer. The powerful dashboard goes even further to allow users to analyzer their revenue by therapy mix, a 12 month net revenue to cash trend, and a breakdown by line of business for the different physician

SCORECARD – TOTAL NET REVENUE

The Net Revenue element is the total expected revenue for the selected period of time in the date filters. This number takes into account any revenue adjustments based on the Adjustment Categories set up in the Data Extensions of the Company Setup. Run the 1243 – Revenue Analyzer for the same period of time as the dashboard. Since this element takes into account Revenue Adjustments, also run the 1245az – Adjustments Aging Analyzer by Billed Month and Adjustment Type to identify any revenue adjustments.

SCORECARD – TOTAL UNIQUE PATIENTS

The Total Unique Patients element shows the total number of unique patients as of today. Run the 1040e –

Patient Census report and keep the parameters as default to validate the total unique patients.


SCORECARD – NET REVENUE BY THERAPY

The Net Revenue by Therapy scorecards allow users to drill down on a specific therapy to see the payers who are responsible for the revenue for the therapy and to identify your top payer for a specific therapy. To validate this, run the 1243 – Revenue Analyzer and group by Therapy. When drilling down on a therapy in the dashboard, change the parameters to add Payers as secondary group.

FILTER – PAYERS

This element shows payors in descending order by total revenue. By clicking a payor in this element, it will show

the therapies assigned to that specific payer on the corresponding elements alphabetically. A “Blank” in the payor

field denotes no payor assigned. To validate this, run the 1243 – Revenue Analyzer and group by Payer and

Therapy.

FILTER – CORE SELECTION

By setting up your Core and Non-Core Therapies in the Data Extensions of the Company Setup, you have the

ability to filter the information displayed on the dashboard to only show those therapies that are of most

important to your business and see which physician that revenue is coming from. Therapies not assigned to

“Core” or “Non-Core” will show up as “other” in the selector. To validate this, run 1243 – Revenue Analyzer and

group by Core/ Non- core Therapy and Invoice Therapy. Payer can be added as tertiary grouping to see revenue

break down by Payer. The Core/ Non- Core grouping is based on the Data Extensions of the Company Setup. Users

without CPR+ Analytics will not be able to run reports grouped by Core/ Non- core therapy.

PIE CHART – NET REVENUE BY LINE OF BUSINESS

The Net Revenue by Line of Business pie chart breaks down the revenue based on the Lines of Business as set up

in the Date Extensions of the Company Setup. Run the 1243 – Revenue Analyzer for validation and group by Line

of Business. Payer, Core/ Non- core Therapy. Invoice Therapy can be added in the grouping options to drill down

further. Line Business Grouping is based on the Data Extensions of the Company Setup. Users without CPR+

Analytics will not be able to run reports grouped by Line of Business.

TRENDING GRAPH – 12 MONTH NET REVENUE VS. CASH


posted based on the ending date of the time period. Net revenue is the expected revenue minus revenue

adjustments entered. To validate this, you need to run three reports. Run the 1072z – Cash Posting Journal for

the same time period as the dashboard with Posted Month as the primary group. Run the 1243 – Revenue

Analyzer and pick Billed Month as the primary group. Also, run the 1245bz – Adjustments Aging Analyzer with

the same date range and parameters and subtract the adjustments from the expected revenues.

TRENDING GRAPH – 12 MONTH PATIENT / INVOICES COUNTS

The 12 Month Patient / Invoice Counts graph shows the number of invoices billed and unique number of patients

billed for the last 12 months based on the ending date of the time period. To validate this, run 1243 – Revenue

Analyzer for the past 12 months with Billed Month as the primary group and make note of the number of patients

and the number of invoices.


DASHBOARD – REVENUE DETAIL BY PHYSICIAN

The Revenue Detail by Physician drill down dashboard allows providers to see where their revenue is coming from

by showing revenue distribution by physician. This powerful dashboard goes even further to allow users to

analyze their revenue by therapy mix, a 12 month net revenue to cash trend, and a breakdown by line of business

for the different physicians.


The Net Revenue element is the total expected revenue for the selected period of time in the date filters. This

number takes into account any revenue adjustments based on the Adjustment Categories set up in the Data

Extensions of the Company Setup. Run the 1243 – Revenue Analyzer for the same period of time as the

dashboard. Since this element takes into account Revenue Adjustments, also run the 1245az – Adjustments

Aging Analyzer by Billed Month and Adjustment Type to identify any revenue adjustments.


The Net Revenue by Therapy scorecards allow users to drill down on a specific therapy to see the payers who are

responsible for the revenue for the therapy and to identify your top payer for a specific therapy. To validate this,

run the 1243 – Revenue Analyzer and group by Therapy. When drilling down on a therapy in the dashboard,

change the parameters to add Payers as secondary group.

FILTER – PHYSICIAN ON CLAIM

The Physician on Claim filter shows a list of physicians in descending order based on highest net revenue. Net

revenue is defined by the expected revenue minus any revenue adjustments. Users can hover over a physician

name to see the total amount of revenue associated with that physician. Furthermore, by clicking on a physician,


the therapy scorecards and line of business graph change to show a breakdown for only that physician. Physician

pulls from the physician associated with the claim. Run 1243 – Revenue Analyzer and group it by Physician to

validate the revenue each physician has earned. Then add Invoice Therapy as secondary grouping to see revenue

grouped by Therapy within Physician.





















the same date range and parameters and subtract the adjustments from the expected revenues.

TRENDING GRAPH – 12 MONTH PATIENT / INVOICE COUNTS.





DASHBOARD – REVENUE DETAIL BY STATE

Revenue Detail by State drill down dashboard allows executives of specialty pharmacies and multi-state infusion

and HME providers to see how revenue is concentrated across the United States. This powerful dashboard goes

even further to allow users to analyze their revenue by therapy mix, a 12 month net revenue to cash trend, and a

breakdown by line of business.



The Net Revenue element is the total expected revenue for the selected period of time in the date filters. This

number takes into account any revenue adjustments based on the Adjustment Categories set up in the Data

Extensions of the Company Setup. Run the 1243 – Revenue Analyzer for the same period of time as the

dashboard. Since this element takes into account Revenue Adjustments, also run the 1245az – Adjustments

Aging Analyzer by Billed Month and Adjustment Type to identify any revenue adjustments.


The Net Revenue by Therapy scorecards allow users to drill down on a specific therapy to see the payers who are

responsible for the revenue for the therapy and to identify your top payer for a specific therapy. To validate this,

run the 1243 – Revenue Analyzer and group by Therapy. When drilling down on a therapy in the dashboard,

change the parameters to add Payers as secondary group.










FILTER – NET REVENUE BY STATE

The Net Revenue by State map of the United States displays revenue distribution by state with darker colors

showing higher revenue concentration versus lighter colors. By clicking on a state, users can drill down on the

state to see revenue for the therapies in that state. Patients who do not have a state assigned will not show up on

this element. To validate, run the 1243 – Revenue Analyzer and group it by Patient State. Then add Invoice

Therapy as secondary grouping to validate revenue grouped by Therapy within State.













the same date range and parameters and subtract the adjustments from the expected revenue.

TRENDING GRAPH – 12 MONTH PATIENT / INVOICE COUNTS





DASHBOARD – REVENUE MANAGEMENT

The Revenue Big Picture Dashboard allow you to see trending of both unbilled and revenue to cash metrics.

Instantly analyze your revenue vs. monthly goals as well as Identify key revenue metrics such as unexpected

denials and unconfirmed tickets. Analyze revenue by payers and unbilled by status.


GAUGE - REVENUE VS. GOAL

Identify the revenue targets for each CPR+ site and enter it into the monthly target for the current month at

minimum. Then use this element to monitor if revenue goals are being met throughout the month. The arrow on

the gauge points to where the revenue goal is and the needle shows where the company stands for the month as

compared to the goal. The number below the gauge allows users to quickly see the amount of revenue needed to

meet the monthly goal. Run 1243 – Revenue Analyzer to validate this. Since this element takes into account

Revenue Adjustments, also run the 1245az – Adjustments Aging analyzer by Billed Month and Adjustment Type

to identify any revenue adjustments.

SCORECARD – REVENUE (MTD)

The Revenue scorecard is the total expected revenue for the current month to date. This number takes into

account any revenue adjustments based on the Adjustment Categories set up in the Data Extensions of the

Company Setup. Run 1243 – Revenue Analyzer and pick MTD as date range to validate this.

SCORECARD – REVENUE (LBD)

This scorecard gives the expected net revenue for invoices billed on the last business day. Run 1243 – Revenue

Analyzer to validate this.

SCORECARD – UNCONFIRMED TICKETS > 2 DAYS

This scorecard shows the number of tickets that were delivered more than 2 days ago that have not yet been

confirmed. Run the 1169c – Unconfirmed Delivery Tickets analyzer report and enter the date two days ago to

show tickets that are unconfirmed and delivered prior to that date.


SCORECARD – UNBILLED REVENUE

The Unbilled Revenue scorecard is the current total of the expected amount on billable items on delivery tickets

that are confirmed but have not been assigned to an invoice. To validate this, run 1025j – Unbilled Aging

Analyzer or the Ticket Cube (Filter on Unbilled)

SCORECARD – RTB TICKETS

The Ready to Bill Tickets scorecard is the number of tickets that are confirmed but not associated with an invoice

and are in a status of “Ready to Bill.” To validate this, run the 1025j – Unbilled Aging Analyzer and note the count

of tickets that are currently in the ready to bill status.

SCORECARD – PENDING REVENUE

The Pending Revenue scorecard shows the expected revenue on invoices that have been created but are pending.

Run the 1243f – Pending Revenue Analyzer to validate this scorecard and dive deeper. The report will ask for a

date range and an “all time” date range should be entered to include all of the pending revenue.

SCORECARD – UNEXPECTED DENIALS

The Unexpected Denials scorecard gives the number of UNIQUE invoices that had denials posted this month that

were not marked as expected in CPR+. Run the 1140d – Denials Posted Analyzer for the current month to date

and group the report by Denial Code. Note the count for Unexpected Denials (# Invoices)

SCORECARD - REVENUE VS. GOAL (T)

This scorecard is the revenue billed today versus the daily revenue goal. The daily revenue goal is the sum of the

monthly goal divided by the number of business days in the month. The first number is the daily revenue goal,

then a percentage to see if that goal is being met, and final the amount over or under the daily goal. Run 1243 –

Revenue Analyzer and pick today as date range to validate this.

SCORECARD - REVENUE PROJECTION

The Revenue Projection scorecard is an indicator of whether the monthly revenue goal will be met. It takes into

account the total time passed in the month and the total revenue versus goal for the month. The Business Days

rules are used to calculate this element. Run 1243 – Revenue Analyzer MTD to validate this.

SCORECARD - AVERAGE DAYS TO BILLS

The Average Days to Bill scorecard calculates the number of days from the start date of service to the date the

invoice was billed. This looks at only invoices billed for the current month.

SCORECARD - TICKETS < 5 DAYS OF TIMELY FILLING

This element shows how many tickets are within 5 days of the timely filing deadline. This requires that the payers

have timely filing deadlines setup in CPR+. Run the 1329a – Timely Filing Alert – Unbilled Tickets report and

identify all invoices within 5 days of the timely filing deadline.

TRENDING GRAPH – REVENUE AND CASH TRENDING – LAST 12 MONTHS TO DATE


posted based on the ending date of the time period. Net revenue is the expected revenue minus and revenue





the same date range and parameters and subtract the adjustments from the expected revenue.

TRENDING GRAPH – UNBILLED HISTORY LAST 6 MONTHS

The Unbilled History for the last 6 months including the current month with unbilled broken down by where the

revenue was in relation to the ready to bill status on the ticket. This shows historical information only available

because of data captured by the Rock-Pond Data Engine on the last day of each month. To validate this, run 1025j

– Unbilled Aging Analyzer for the last 6 months.

PIE CHART – REVENUE TOP 10 PAYORS

The Revenue for Top 10 Payors pie chart shows revenue for top payors for the current month. All other payors

are grouped in “Others.” Run 1243 – Revenue Analyzer and group by Payor to validate this.

PIE CHART – UNBILLED REVENUE BY STATUS

The Unbilled Revenue by Status list gives a breakdown of unbilled revenue grouped by the ready to bill status.

Use the 1025j – Unbilled Aging Analyzer or the Unbilled by Ready to Bill Status global shared layout to validate

this.

CPR+ ANALYTICS CUBE – ANALYZE

CUBE – REVENUE CUBE

Increasing revenue is the number one goal of any company since it allows you to stay in business. It is crucial that

you see where your revenue is coming from, how it is trending, how much revenue is pending, and where you are

missing opportunities. Revenue cube does just that!

GLOBAL LAYOUT – BILLER PRODUCTIVITY

The layout [Rock-Pond] Biller Productivity was made global for all users. It will give you an overview of your biller

productivity by listing their Expected Revenue. Note that the layout pulls the user who creates the transaction,

not necessarily the person that processes it. Discover the layout in the drop down list or within the layout

manager and use it as a starting point to manage your biller.

In order to build this layout, these are the steps you need to take:

Row Area: User Invoice Creator Full Name

Data Area: Expected Revenue

GLOBAL LAYOUT – TRENDING REVENUE BY THERAPY

The layout [Rock-Pond] Trending Revenue by Therapy was made global for all users. It will give you an overview

of your revenue by therapy over a period of time. Discover the layout in the drop down list or within the layout

manager and use it as a starting point to analyze your revenue trending. For example, filter the month and year to

see your revenue for the whole year or the same period of time every year. In addition, you can pull in Payor Type

instead of Therapy to see your revenue trending by Payor Type.


Row Area: Invoice Therapy and Invoice Date Billed (Year)


Column Area: Invoice Date Billed (Month)

Data Area: Expected Revenue

CUBE – PROFITABILITY CUBE

Increasing profitability is the number one goal of any company since it allows you to stay in business. It is crucial

that you see where you are profitable as well as where you are losing money. Profitability cube helps you analyze

this aspect of your business in an invoice level by looking at line item collectively, instead of looking at individual

drugs.

GLOBAL LAYOUT – INVOICES WHERE COST EQUALS ZERO

The layout [Rock-Pond] Invoices where Cost Equals Zero was made global for all users. It will give you a list of all

invoices that has no cost. Discover the layout in the drop down list or within the layout manager and use it as a

starting point to analyze these errors and take action as needed.


Row Area: Invoice Site Name and Invoice Number

Data Area: Invoice Expected Revenue, Invoice Cost (show value from [blank] to $0.00), Invoice Total Payments, and Invoice Total Adjustments.

GLOBAL LAYOUT – INVOICES WHERE THE MARGIN IS LESS THAN OR EQUALS TO 3%

The layout [Rock-Pond] Invoices where the Margin is Less than or Equals to 3% was made global for all users. It

will give you a list of all invoices with profit margin of 3% or less. Discover the layout in the drop down list or

within the layout manager and use it as a starting point to pin point exactly where you are not making money or

whether these are errors that need to be fixed.


Filter Area: Invoice Date Billed (Year) and Invoice Date Billed (Month)

Row Area: Invoice Number

Data Area: Invoice Expected Revenue, Invoice Cost, Invoice Total Payments, Invoice Total Adjustments, Invoice Expected Gross Profit, and Invoice Expected Gross Profit Margin (filer to show value from [blank] to 3%)

GLOBAL LAYOUT – PROFITABILITY BY PAYOR TYPE

The layout [Rock-Pond] Profitability by Payor Type was made global for all users. It will give you an overview of

your Expected Revenue, Cost, Payments, Adjustments, Gross Profit, and Margin by Payor Type. Discover the

layout in the drop down list or within the layout manager and use it as a starting point to analyze your

profitability. For example, instead of Payor Type, you can pull in Therapy and see your profitability by Therapy.


Filter Area: Invoice Date Billed (year), and Invoice Date Billed (Month)

Row Area: Billed Payor Type

Data Area: Invoice Expected Revenue, Invoice Cost, Invoice Total Payments, Invoice Total Adjustments, Invoice Expected Gross Profit, and Invoice Expected Gross Profit Margin.

REVENUE PROFITABILITY - Rock-Pond Solutions – Cash vs. Goal ... Global Layout – Profitability by...

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