Description

Screen where the claims and reconciliation flow and tips will be displayed. 




Access

From the Billing screen press the Helpbutton. 



Sections

  • Status Explained: A summary or explanation of the status of possible scenarios when creating claims or performing reconciliations. 
    • New/Pending/Printed: From Unbilled Services. Manually created. Printed 1500/UB04.
    • Transmitted/Re-Transmitted: Tx - ed no response yet. Check for responses and or continue. 
    • TrasnsAccepted/ Errors: Clearinghouse accepted. Use editor to fix errors. No payer response yet.  
    • Disputing/Secondary: Payer did no pay enough. Re-Transmit to Payer. Secondary Claim to another. 
    • Paid/Rejected: Insurance pay exhausted. Show's up on Patient Collections. 
    • Closed: Insurance and/or patient paid or assumed Loss/ Write off. Removed from Aging.
  • Recommended Service to Claim Lifecycle: Steps recommended to follow for the Lifecycle claims.
  • Invoice
    • Eligibility Screen: Check Recorded in log as Dispute Evidence
    • Patient Details: Copied from Eligibility. Enter Details and scan insurance card. Update if necessary.
    • Clinical Visit: Close note. Add billing procedures and F Codes. 
    • Unbilled Encounters: 
    • Create Claims: From encounters. Data entry / Manual. 
    • Claim Editor: Fix / Modify. Check history. Create secondary. 
    • Claims Aging: Manage. Print paper claims. Re-Transmit / Export. Reports.
    • Reconcile Payments
      • Patient Payments: Pre-payments. Unbilled encounters. Post-Payments, Paid, Rejected, Past Due Collections. 
      • Reconcile Payments: Electronic vouchers and Data entry. 
      • Electronic Vouchers 835: Match claims. Create empty claims. Create payments. 
      • Data Entry: Mail/ Paper. Payments.
    • Reportes y Balances
      • Billing Dashboard for Excel: Exports all transactions to excel in order to create reports. 
      • Closed Claims: Reports. Closed with balance.