ChiroTouch will produce dozens of reports. Most billing questions a practice actually has are answered by about seven of them — and each one carries a caveat that, if you miss it, turns a correct report into a wrong conclusion.
This is the list we ask for, what each one answers, and the trap in each.
The seven
| Report | What it answers |
|---|---|
| Insurance Collections | What insurers were expected to pay versus what they actually paid, by payer. |
| Aged Outstanding Claims | Every claim line billed, its status and its age. The only report that supports an honest cohort collection rate. |
| Aged Patient Receivable | What patients owe, by age bucket — and, critically, unallocated cash sitting on their accounts. |
| Aged Payer Receivable | The same for insurers. Separating the two is the first step in knowing who you are actually waiting on. |
| Payment Detail by Method | Every payment, how it arrived, and whether it was applied. This is where unapplied cash shows up. |
| Adjustment Detail by Provider | Every write-off with its reason code. Without this you cannot compute a net collection rate at all. |
| Procedure Code Productivity | Volume, charges and collections by CPT. Where you find out which services actually pay. |
Two more are worth pulling when the question warrants it: Rendering Provider Monthly Charges & Collections for multi-provider practices, and End-of-Day Appointments when the question is about schedule utilisation rather than billing.
The traps
1. Insurance Collections is a billing-date window, not a service-date window
The report's own footnotes say it: it includes only charges initially billed during the range. It is not date-of-service. If your practice had a billing backlog — a system migration, a staffing gap, a holiday week — claims for old services flow into the window and blend service periods you thought were separate.
It also shows the primary policy only, and excludes secondary billings and payments entirely. Every collection rate it produces is therefore understated. Real performance is somewhat better than the report shows — which is the opposite of the direction most people assume a disappointing report is wrong in.
2. Adjustment codes are not interchangeable
The reason code is the entire analysis. Three you will meet immediately:
- CO-45 — charge exceeds the fee schedule. This is the contractual write-down and it is the one you subtract to get a net collection rate.
- Patient-side write-offs — typically an OA code with a practice-defined label. These bundle time-of-service discounts together with genuine bad debt. They are opposite things and must be separated by age, population and amount pattern before either number means anything.
- Prior-payment or conversion codes — migration debris. In one engagement these decayed from $11,723 to $80 over three months, which is how you know they were never economic events.
Check the code definitions in your own system before analysing anything. In ChiroTouch they live under the billing-codes settings, and the label your practice chose is often more informative than the code itself.
3. A system migration poisons the window it sits in
If your practice changed systems, the cutover month is not comparable to anything. In one case the migration dumped $247,554 of artifact adjustments into a single month. Any twelve-month analysis whose window straddles that month will produce nonsense.
Equally, do not accept "the old system's data is gone" without testing it. It usually isn't — legacy systems are frequently still reachable for read-only pulls, which is how you get a genuine year-over-year comparison instead of guessing.
4. Unit counts do not mature. Dollars do.
A common error is explaining a drop in procedure volume by "collection lag." Collections mature as claims post. Unit counts do not. If units fell 25–68% across nearly every code between two periods, the likely explanation is a definitional difference between two systems, not lag — and comparing volumes across a system boundary is usually not a valid comparison at all.
Pull discipline: the part everyone skips
Wait for runout. Never pull a collections window the day it closes. Give it 30 to 45 days. A rate measured on a fresh window is measuring the software's estimate, not the payer's obligation — and it will improve by several points on its own.
Record the pull date. ChiroTouch does not store it in the file. If you don't write it down at export time, you cannot reproduce or defend the number later.
Rename the file immediately. Exports download with auto-generated names like
1$8472913.xls. Sixty of those in a Downloads folder is how provenance gets lost.
A convention that works: Practice_Report_YYYYMMDD-start_YYYYMMDD-end_pulledYYYYMMDD.xls,
plus a one-line register recording what each file is. Dull, and it prevents the single most expensive
class of mistake in this work — analysing the wrong file and not finding out for a week.
If you are being asked for reports by a consultant or billing company, ask which of the seven they want and over what window. If the answer doesn't include Adjustment Detail, they cannot compute a net collection rate, whatever they tell you the number is. And if they want a window that closed last week, ask them to wait a month.