Check the Vital Signs of your Medical Practice
A medical practice is a unique business in many ways, but it is still a business and must be treated as one. Checking the health of your practice is similar to checking the health of your patients. In this three-part paper, we look at three vital signs, pulse, blood pressure and temperature, to help you assess the financial health of your medical practice.
Pulse
How many new patients are you seeing each month?
By analyzing the trends month over month, you can calculate your current growth rate and estimate whether you will need more staff or other infrastructure changes. If close monitoring of your patient numbers shows a steady decline or a steep increase, you have the chance to research the reason. One reason could lie in the next item on our list, referrals.
Who is referring those patients to you?
The internet lets physicians reach a wider range of patients more easily and at lower cost. Many people with basic medical needs are comfortable choosing a doctor online, but many others have complicated conditions. Their referrals generally come from colleagues and satisfied patients. Know which providers in your area refer patients to your office, and keep communication open about those shared patients. A happy, well-cared-for patient is the best advertising. Poor service from office staff can drive away patients who like their doctor, and word of those unpleasant episodes can reach the referring colleague. Watch for trends that show fewer referrals from a particular source, and take the time to reach out personally.
These two reports are a small sample of the practice management reports built into the Report Center module of Iridium Suite medical billing software.
Blood pressure
Are the numbers of services you bill increasing, decreasing or staying the same?
Depending on your type of practice, you may bill one or two procedure codes per patient visit, or, in some specialties like radiation oncology, 10 procedure codes per visit. In either case, reports that show month-to-month statistics help you recognize unusual patterns in your billing. A sharp decline in a certain procedure may point to forgotten or missed coding, and therefore missed revenue. Many payers have timely filing limits counted from the date of service. They can range from 60 days to one year. A regular review for missed charges will help you meet those filing limits and collect for all of the services you provided.
If your report shows an unexpected procedure, or an unusually high number of a certain procedure, you can audit the medical records for proper documentation. If you find billing errors, you can act before an insurance audit by quickly refunding any payments received for services that were not provided. Staying in good standing with your payers is always important.
Is your claim reimbursement in line with your contracted fees?
This analysis is valuable to any medical practice. Once you have signed a contract with a payer, you should make sure you receive the proper reimbursement at the agreed contract rates. In a busy medical office, staff seldom have time to check every paid line item. A monthly report that compares payments received to the payer’s fee schedule will show payments that are below, as well as above, the payer’s contracted fees. Payments below the contracted fee should prompt an immediate call to the payer’s Provider Relations department. For payments above the contracted fee, check the accuracy of the fee schedule you are using. For instance, the payer may have updated its schedule and you have not. This report can also show you overpayments. If you refund them to the payer before the payer asks, the payer will see that your practice follows proper procedures.
These two reports are a small sample of the practice management reports built into the Report Center module of Iridium Suite medical billing software.
Temperature
What is the aging breakdown of your accounts receivable?
A basic accounts receivable report typically groups the money due into aging “buckets”:
- Less than 30 days
- 31-60 days
- 61-90 days
- 91-120 days
- 121-150 days
- Over 151 days
Ideally, the largest share of your receivables is in the less than 30 days bucket, and the balances get smaller in each older bucket. The older the receivables get, the harder it is to collect from the payer. Unresolved balances also build up into a growing amount of work if they are not handled on time. The backlog can become so large that office staff may not know where to start.
Do you have procedures to make sure money due is collected quickly?
When you analyze your receivables in the 31-60 days bucket by payer, you can see whether most of that money is secondary payer balances. Because of processing turnaround time, it is normal to see secondary payer balances in this bucket, and to some extent in the 61-90 days bucket. If you see a large amount of primary payer money in the 31-60 days bucket, check the claim status with the payer. The payer may not have received the claim, and you may need to resubmit it to avoid timely filing problems. If you wait until those claims reach 61-90 days or more, it could be too late.
Work claim denials often: daily as the payer sends them, or at least monthly during the accounts receivable analysis. Payers also have timely filing limits for appeals, usually only 60 to 180 days after the date of the EOB. The sooner you send the appeal, the sooner you may receive your reimbursement.
These two reports are a small sample of the practice management reports built into the Report Center module of Iridium Suite medical billing software.
Regular check-ups
Now that we have reviewed the vital signs of a medical practice, follow the same advice you give your patients: schedule regular check-ups to keep your practice healthy. Medical practice management software like Iridium Suite has built-in report scheduling to help you keep a close watch on the pulse, blood pressure and temperature of your medical practice.
What has changed since this was written
- Radiation oncology procedure trends reset in 2026. On January 1, 2026, CPT replaced the IMRT, IGRT and G-code delivery families with 77402, 77407 and 77412, so month-to-month counts of the old codes are no longer comparable. See the 2026 radiation treatment delivery codes.
- Check payments against new contracted rates. Some payers did not update their fee schedules for the 2026 radiation oncology codes, which makes the payment-to-contract comparison in this paper more important. See why 2026 radiation oncology payment cuts fell more than projected.