Monthly Reimbursement Trend (REM)

Monthly Reimbursement Trend (REM) provides insight on claim payment breakdowns. A monthly-trended distribution of claim charges is divided into four groups: Denied Charges, Contractual Adjustments, Patient Responsibility, and Payer Payment. This information is shown per each CID as well as LOB.

Business Use

Monthly trending of how payers adjudicated charges. Charges are broken into Payments, Patient Responsibility, Contractual Adjustments, and Denials.

Running the Report

To generate the Monthly Reimbursement Trend (REM) report:

  1. Click Run on the Monthly Reimbursement Trend (REM) report pod.
  2. Select the option of whether or not to include test claims.
  3. Select one or more CIDs from the values displayed.
  4. Use the calendar function to enter a Payment Date (Start).
  5. Use the calendar function to enter a Payment Date (End).
  6. Click Run Query.

Tab Views and Field Descriptions

See the following pages for details on these tabs:

This tab shows a monthly-trended distribution of claim charges by denied charges, contractual adjustments, patient responsibility, and the total payer payment. A chart is displayed for each Client ID.

Field Description
<Month> <Year> Payment date.
Payer Payment Percentage of total charges adjudicated as Payer Payment.
Patient Responsibility Percentage of total charges adjudicated as Patient Responsibility.
Denied Charges Percentage of total charges adjudicated as Denied Charges.
Contractual Adjustments Percentage of total charges adjudicated as Contractual Adjustment.
Bundled Charges Percentage of total charges adjudicated as Bundling Adjustment.

This tab provides a comparative view into LOBs within each CID.

Field Description
<Month> <Year> Payment date.
Payer Payment Percentage of total charges adjudicated as Payer Payment.
Patient Responsibility Percentage of total charges adjudicated as Patient Responsibility.
Denied Charges Percentage of total charges adjudicated as Denied Charges.
Contractual Adjustments Percentage of total charges adjudicated as Contractual Adjustment.
Bundled Charges Percentage of total charges adjudicated as Bundling Adjustment.