What medical billing reporting from Fastora covers
Good medical billing reporting answers three questions every month: how much did we collect, what slowed payment down, and what is being done about it. Fastora provides transparent dashboards, monthly performance reporting and a monthly review call, with custom reports available on request.
Reports are built from the data in your own practice management system, so the numbers reconcile with what your front desk and managers see. We add the context a raw export lacks: which payer changed a policy, which denial reason grew, and which fix is already underway.
The KPIs we report
We focus on a short list of measures that point to a specific part of the revenue cycle. Our guide to medical billing KPIs explains how each one is calculated. Each measure is shown for the practice as a whole and can be split by provider, location and payer.
| KPI | What it measures | What it tells you |
|---|---|---|
| Clean claim rate | Claims passing pre-submission edits without correction | Whether registration and coding are feeding clean data into claims |
| First-pass rate | Claims paid on the first submission | How much rework and delay the cycle is creating |
| Denial trends | Denials by reason code and payer over time | Which step, payer or policy is causing lost or delayed payment |
| Collections vs. charges by provider | Payments received against billed charges for each provider | Coding, documentation or fee schedule differences between providers |
| AR days outstanding | Average days from service to payment | Whether follow-up is keeping pace with new claims |
We report these as trends, not single snapshots. One month's figure can move for harmless reasons, such as a payer's processing backlog; a three-month trend is harder to explain away. Where a number moves sharply, the report notes the cause we found and the action already taken, so you are not left to interpret it alone.
Reading denial trends by reason and payer
Payers explain adjustments on the remittance with standard claim adjustment reason codes (CARCs), often paired with remittance advice remark codes (RARCs). We group those codes into categories that match the steps of the cycle: eligibility, authorization, coding, missing information, duplicate claims and timely filing.
Grouping by category and payer turns a long denial list into a short set of actions. A rise in eligibility denials from one payer points to front-end checks, while a rise in coding denials for one service points to documentation or code selection. The day-to-day work of correcting and appealing those claims is handled through denial management.
Revenue cycle optimization: turning reports into fixes
Revenue cycle optimization is the practical step after reporting. Each month we connect what the numbers show to a specific change and check the next month whether it worked.
- Eligibility denials rising: add or tighten insurance checks before the visit through eligibility verification.
- First-pass rate falling for one payer: review recent payer policy changes and update claim edits.
- A gap between one provider's charges and collections: run a focused coding review and compare payments with the contract.
- AR days climbing: rebalance follow-up toward older, higher-value claims through AR management.
- Payments below contracted rates: send affected claims for underpayment recovery.
Payer-level reporting
Most revenue problems are payer problems. A payer that changes a policy, slows its processing or starts paying below contract affects every claim you send it, so we break the core measures down by payer as well as by provider.
Payer-level views show how long each payer takes to pay, which payers generate the most denials and for what reasons, and where payments fall short of the fee schedule you expect. That information is useful for day-to-day follow-up, and it is also the evidence you need when raising problems with a payer representative or reviewing a contract.
We also report your payer mix over time. A shift toward plans with more authorization requirements or lower payment rates can change collections even when visit volume stays level, and it is better to see that early.
What the RCM reporting dashboard shows
The monthly report explains what happened; the RCM reporting dashboard shows where things stand between reviews. It draws on the same data, so the figures on screen match the figures in the report and the review call.
- Claims: submitted, accepted, rejected and still open, by payer and date of service.
- Denials: new denials by reason code and payer, and which ones are already in appeal.
- Collections: payments posted against charges, by provider and location.
- AR: balances by aging bucket, with the oldest claims and those nearest filing limits listed first.
- Patient balances: statements sent, payment plans in place and balances still unpaid.
Each view can be filtered by provider, location and payer, so an office manager can answer a specific question without asking for a new export.
Your monthly performance review
Each month your dedicated account contact walks through the report with you on a call. The review covers collections and charges, denial trends, AR by aging bucket, open issues from the previous month and the fixes planned for the next.
The call is in plain language and built around decisions: which payer to escalate, whether to change a front-desk step, or whether a provider needs coding feedback. Between calls, the dashboards stay available and 24/7 dedicated client support is there for questions.
Custom reports on request
Some practices need a view the standard report does not include, such as results by location, by referring provider, by payer class or for a single service line. Custom reports are available on request.
If you already track numbers in your own spreadsheets, we can match the definitions you use, so month-to-month comparisons stay consistent after you start working with us.
Custom reporting is also useful before contract talks with a payer, when you need payment history by code and payer in one place. Reporting sits alongside the rest of our revenue cycle management work, so the same team that produces the numbers is responsible for acting on them.
Month-end close and reconciliation
Month-end close is the reconciliation of payments to deposits: every ERA and paper remittance matched to what actually landed in the bank, contractual adjustments checked against payer contracts, and patient payments tied to the right accounts. It is unglamorous, and it is where small errors compound — a misposted payment today becomes a phantom balance next month. Our close runs on a fixed monthly calendar, so the numbers in your report are the numbers that reconciled.
What does reconciliation catch that reports alone miss?
Reports show what was posted; reconciliation shows whether what was posted matches the money. It catches duplicate postings, contractual adjustments taken at the wrong rate and deposits that never made it into the system — the items that make two reports disagree.