Start with a fair comparison
Compare the same number of business days and completed visits, not just calendar months. Check the bank deposits and the reports behind the original number. Payments often arrive after the visits that generated them, and the timing varies with payer mix. A short-term timing shift is different from a sustained change in collections.
Trace the difference through the work
Check whether completed visits changed, including cancellations and no-shows. Then compare payer mix and payment per visit. On the billing side, look for changes in claims submitted, clearinghouse acknowledgments, rejections, denials, underpayments, and posting delays. Review accounts receivable by age and payer to see whether unresolved balances are accumulating in a particular segment.
Patient collections and payment-processing issues may also affect deposits. Keep these checks separate from insurance claim performance so the practice can see which parts of the total moved.
Decide what the evidence supports
Write down the periods compared, the data sources, what changed, what remains unknown, and the next checks underway. A drop in one report does not by itself show that a payer, vendor, or employee caused the change. Confirm the pattern in the underlying records before assigning a cause.
If billers find a paid claim that appears lower than the applicable contract amount, they can investigate it separately from denials. They may review the remittance and contract, then contact the payer or use its dispute process when appropriate. Identifying a variance does not guarantee additional payment.
For a structured metric set, see physical therapy billing KPIs and how to read a PT accounts receivable aging report.