Agreed rates, not billed rates
Two reports. Same payer, same seventeen months, same 4,400 claims.
One says you are owed $234,000. The other says $140,000.
Neither of them is wrong. They are answering different questions. The trouble is that nobody wrote down which question was asked, and a ninety-four thousand dollar difference is a lot of weight to put on an assumption.
The two numbers
A billed rate is what went out the door. It is the amount on the claim — the charge, the ask, the number your system put in the box.
An agreed rate is what the contract says you will be paid. It is the number that survives adjudication.
For most practices these are not the same, and they are not meant to be. Charge masters are commonly set above contract deliberately, so that a payer with a higher schedule is never billed below what it would have paid. The contractual adjustment closes the gap on every claim.
All of that is normal and none of it is a problem. What is a problem is building a receivable on the billed number and then making decisions with it.
Why the receivable inflates
If your A/R is calculated from billed amounts, every open claim carries the full charge rather than the contracted amount. The difference is not a receivable. It is a contractual adjustment that has not been booked yet, and it will disappear the moment the claim adjudicates.
On a book where the charge master sits 40 percent above contract, an A/R of $234,000 on billed rates is around $167,000 on agreed rates before you have found a single error. The rest was never collectible from anyone.
Then you start finding the real problems — cash never posted, claims priced wrong, adjustments voided in error, balances past timely filing — and the number falls again. On the completed engagement published on this site, the reconciled figure was $139,998.
The $94,000 gap between the system’s number and the real one was not fraud and not incompetence. Most of it was a reporting basis nobody had chosen on purpose.
Which field, specifically
In CentralReach the fields you want are the agreed ones. `ClientChargesTotalAgreed` at the claim level, `RateClientAgreed` at the line level. They are not the defaults on every export and they are not what most report templates reach for first.
The billed equivalents sit next to them, named similarly enough that an export can carry the wrong one for a year without anyone noticing. A revenue figure built on the billed field will be consistently and invisibly high, and it will reconcile to nothing.
This is the single most common cause of a practice’s internal revenue number disagreeing with its accountant’s.
Say it on the deliverable
Any report that states a revenue or receivable figure should say which basis it used, on its face, where the reader cannot miss it.
Not in a footnote. Not in the file name. On the page, next to the number.
*Basis: agreed rates (RateClientAgreed), by code and date of service.*
It reads as pedantic right up until the first time two reports disagree and the basis line settles it in four seconds instead of an afternoon. After that it reads as competence, and people start asking for it.
A number without a stated basis is not a number. It is an opinion with decimal places.
What changes when you switch
Expect the revenue line to fall and the margin picture to improve. Those move together, and the reason is worth understanding.
Revenue falls because the contractual adjustment comes out. Margin improves in clarity — not in reality — because you are finally comparing real revenue to real cost, rather than an inflated top line to an accurate cost line, which is what makes so many ABA P&Ls look better than the bank account.
If you have been forecasting on billed rates, the first accrual close on agreed rates will feel like a bad month. It is not a bad month. It is the first honest one.
Five checks you can run this week
1. Open your last revenue report and find the basis. If it does not say, you do not know which number you produced. That is the finding.
2. Export the same period twice, once on billed fields and once on agreed. The gap between them is your charge master markup, and you should be able to explain it in one sentence.
3. Reconcile the agreed-rate total to posted cash for a closed period. It will not match exactly — timing, denials, adjustments — but it should be close enough that the differences are individually explainable.
4. Check what your books are on. If the general ledger is booking revenue at billed amounts, the balance sheet carries a receivable that cannot be collected, and every ratio built on it is wrong.
5. Put the basis line on the next report you send, whoever it goes to. Then do it on all of them.
The number to actually track
Every revenue and receivable figure stated on an agreed-rate basis, with the basis named on the face of the deliverable.
Pair it with a reconciliation of the agreed-rate total to posted cash for a closed period. The differences should be individually explainable.
A number without a stated basis is not a number. It is an opinion with decimal places.
Where this sits
This is the seventh of eight stages where ABA revenue leaves. It is the quietest one, because nothing denies and nothing ages. The claim pays, at the wrong number, forever.
This one is a reporting defect rather than a leak, and it is the most common cause of a practice’s internal revenue number disagreeing with its accountant’s.
A Leak Map Assessment measures all eight — the reservoir, authorization burn, cancellations, session conversion, conversion to billed, clean claims, rate integrity and recoupments. A claims audit is a different instrument. It starts once a session has been converted and billed, and reconciles the back half of the cycle to cash.
Aimline closes the books, oversees the revenue cycle, and sits in the CFO seat for ABA practices. We run claims audits scoped to a payer book, and Leak Map Assessments that measure the full cycle — three weeks, $7,500 fixed. Either one gives us a verified number to run oversight against, and the report is yours whether or not you engage us to fix what it finds.
