Hospital + Physician RCM Operating Suite | Service-Line Claims & A/R Excel Review

Make the service-line huddle comparable

Hospital and physician leaders may see the same finance report while counting encounters, claims, and denials at different stages. This manual Excel suite creates a focused, aggregate review across up to 20 service lines, with the reporting period and care setting visible alongside each row.

What the model shows

• Enter eligible encounters, submitted claims, accepted claims, subsequently denied claims, net payments, open A/R, and A/R older than 90 days.
• Calculate accepted claims per submitted claim, subsequent denials per accepted claim, and the over-90-day share of open A/R.
• Use Data Checks to surface missing or inconsistent inputs before interpreting totals.
• Identify which service line needs source validation or an upstream handoff review.

Package contents

One editable XLSX with Executive View, Service Line Review, Read Me, and Data Checks, plus a short quick-start file. Included example rows are fictional. Excel desktop is recommended.

Operating use

Align periods and numerator/denominator definitions, reconcile aggregates to approved source reports, identify an owner for each exception, and record follow-up in your organization’s approved system. A rate difference is a question to investigate; the sheet does not determine payer fault, appeal eligibility, or recoverable dollars.

Start with one hospital line and one physician line. Validate their inputs and take the first source discrepancy to the next RCM meeting.

Use only appropriately governed aggregate data. Do not enter patient identifiers or protected health information. This file does not connect to an EHR, encode payer policy, or establish HIPAA compliance. Confirm applicable policies with your organization.

License, delivery and support

One purchasing organization may use and adapt the workbook internally. Do not resell, redistribute, or deploy it to multiple clients without a separate license. This is a digital download after successful payment; no physical item ships. For a file or access problem, use MetricForgeHQ Contact with your order number and product name. Do not send confidential information.