Monthly Stat Summary

July 24, 2015

Use this simple form to report monthly physician practice management statistics to management.

To download this form, click here: Monthly Stat Summary

Mason Regional Cardiac Surgery, P.C.

Monthly Statistical Report

The monthly statistics report provides a summary of key practice data primarily involving total production, cash collected, surgeries performed and patients seen. When used in conjunction with total monthly expenses and net income, the two documents provide an adequate snapshot of the month’s performance.

Month: ____________________

Total Charges: ____________________

Adjustments: ____________________

Net Charges: ____________________

Total Receipts: ____________________

Adjustments: ____________________

Net Receipts: ____________________

Collection Ratio: ____________________

Number of Surgeries: ____________________

Number of Procedures: ____________________

Total Patient Visits: ____________________

Accounts Receivable: ____________________
Aging: > 30 days ____________________
30-59 days ____________________
60-89 days ____________________
90-119 days ____________________

Rolling 90 day AR average: ____________________

Average Days to Collect: ____________________

Number of Days in AR: __________________

Washington Regional Cardiac Surgery, PC

Monthly Statistical Report

Charges by Payor:

Revenue by Payor

YTD summary


Procedures by Physician (CPT)

Gross Charges by Physician

Net Revenue by Physician

Payor Revenue by Physician

Referring Physician by Physician

A/R aging by Physician

To download this form, click here: Monthly Stat Summary

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