Introduction: Outstanding / Unpaid claims lists the Claims against for which remittance is not yet received.

Sort: It allows sorting of outstanding claims according to sequence chosen on pop up 'outstanding'. Ascending/ Descending sorting up to three columns is allowed.

Select Filter : It displays the pop up 'Outstanding Filter'. Enter value next to field to generate the appropriate outstanding claim's list. The following filters are applicable. It allows you to narrow down outstanding claims list with relevant information.

Action Icons

Patient Billing notes: It invokes a pop-up to display/add patient billing notes.

Claim Notes: It is used to write notes about the claim, for internal documentation purpose.

Track Status: It tracks the claims' status history, as in, the number of times the claim got sent, rejected, and reopened. It displays the pop up 'Track Status Notes' which displays information under columns like 'Name', 'Change On', 'Track Date', 'Code', 'Status Name', 'Comment', 'Message'. You can even print the track statuses using button 'Print' on pop up 'Track Status Notes'.

Patient A/C: It displays a billing report of the patient (highlighted by a blue band) account.
Statement for DOS: It displays the details of services rendered on a particular Date of Service (DOS).
Ledger: It displays the list of all recipts/write-offs/adjustments made by insurance/patients against this claim.

AR Calling: It displays pop up 'AR Calling' which displays the details of the claims selected on Outstanding Claims list. The details are displayed about 'Patient Details', 'Claim', 'Primary Insurance' and 'Secondary Insurance'. User can print 'AR Calling' details for referring it later or even for tarcking purpose with Insurance Companies using button 'Print'.

Assign To: Use this option to assign the selected claim to other PrognoCIS user(s); a message along with date is allowed to be entered. The function applies ONLY to the row that is selected and is applied as a tool tip. To display the tool tip message of 'Assign To' hover your move over the Link under the column: Loc. Refresh the page to view the changes.

Resend Claim: It is possible to resend an already posted claim, if required when 'Resend Claim' icon is clicked. Select claims which are not 'Self Pay' claims to resend the claim.

The columns displayed and which are hyperlinked allows sorting on that specific column in the Outstanding Claims interface. The columns whsich are displayed are

Claim Id: It is Unique Claim Id. It is hyperlinked. Click hyperlink 'Claim Id' to view to the respective Claim screen.

DOS: Date of Service / Encounter Date; if the DOS is displayed in a green background then it implies that the claim has been sent to the Insurance via EDI.

Status: Claim Tracking Status Code is a hyperlinked Status Code that invokes a pop-up 'Claim Status' when clicked. This popup displays whether the claim is a Paper Claim or an EDI Claim, along with its current Claim Track status code (text in blue color and hyperlinked). It also allows user to change the existing claim track status for the claim to an appropriate new claim track status code. Note that when user modifies the claim track status and clicks on OK, the corresponding claim row on the Claims > Outstanding will immediately reflect the new status as hyperlink along with corresponding legend on its tooltip.
Note: All status Codes can be seen by clicking on the button: Legend

Patient: Full Name of the patient.

Provider: Name of Provider.

Sent on: The date on which the Bill was sent.

Insurance: Primary Insurance Company Name.

Loc: Location Code used in claim.

BU: Business Unit Code used in claim.

Charge: Total Billed claim amount.

Balance: Claim Amount that is Outstanding. This field is hyperlinked to display the Charge code wise break up for the Claim.

Assign To: It displays the name of the other PrognoCIS user to whom claim has been assigned using 'Assign To' action.

Assign Date: It displays the date on which specific claim had been asigned to other PrognoCIS user using 'Assign To' action.

Assign Status: It displays the status.

Legends: The button displays a list of status codes along with its details, it is used as reference to track the status codes displaying in the current page.

Count: It displays the total no. of outstanding claims dispalyed on Outstanding Claims screen.

Total Charge/Bal: It displays total Billed amount to claims/ Total outstanding amount to be recovered from outstanding claims. It helps 'Biller' to track these outanding claims as amount upaid is visible at a glance.

print: It allows printing of details of oustanding claims displayed on Outstanding claims screen.

excel: It allows to send the details to XLS file as comma separated file.