PrognoCIS Help: Centralized Claim Assignment

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Introduction: Beside the Search Patient button on the Control Room screen, an Assign button is present. This serves the purpose of Centralized Claim Assignment from a single dedicated screen instead of multiple screens in PrognoCIS. On clicking the Assign button, Centralized Claim Assignment popup is invoked. The Centralized Claim Assignment popup is divided into two sections: Claim Assignment and Summary.

Claim Assignment

The Claim Assignment section consists of Source dropdown, Action Required dropdown, Expected Date field. A table having Clinic, Associates, Claim IDs and Count columns is also a part of the Claim Assignment section.

Field Description:

*Source: This is a mandatory field. Select the source of the assignment from this dropdown. On clicking the SUBMIT button without selecting a source, a validation message, Please select Source. is displayed in a popup with an OK button. The options displayed in this dropdown are populated from Settings → Configuration → Group Types → Non-→ Assignment Source (AF). By default, ‘--Select--’ is selected from the dropdown.

*Action Required: This is a mandatory field. Select the Action that is expected. On clicking the SUBMIT button without selecting the required action, a validation message, Please select Action Required. is displayed in a popup with an OK button. The options displayed in this dropdown are populated from Settings → Configuration → Group Types → Non-System → Assignment Action Required (AA). By default, ‘--Select--’ is selected from the dropdown.

*Expected Date: This is a mandatory field. Set an expected date of completion of an assignment in this field from the Calendar icon provided. On clicking the SUBMIT button without selecting the expected date, a validation message, Please select Expected Date. is displayed in a popup with an OK button. On selecting a date that is less than today’s date and clicking on the SUBMIT button, a validation message, Expected date cannot be less than today. is displayed in a popup with an OK button. By default, this field is blank.

Claim Assignment Table: Claim Assignment Table has Clinic, Associates, Claim IDs and Count columns.

Clinic: Select a Clinic from this dropdown. This dropdown displays all active Clinics from Settings → Configuration → Customer Master screen. By default, ‘--Select--’ is selected from the dropdown.
Associates: Associates stand for Billing Staff. Select an Associate/Billing Staff from this dropdown. Options are displayed in this dropdown only when a Clinic is selected in the Clinic dropdown for that row. On selecting a Clinic, this dropdown displays only those Associates as options that have been assigned to the Clinic on the Customer Master screen or those to whom Clinic has been assigned on the Customer button of the Billing Staff Master screen. By default, ‘--Select--’ is selected from the dropdown.
Claim IDs: Enter comma separated Claim IDs in this text field. The character limit of this field is 250 characters. Click on the Clear link beside this field to remove all entered Claim IDs from the field. On selecting Source, Action Required, Expected Date, Clinic, Associate, entering alphabets or special characters in the Claim IDs field and clicking on the SUBMIT button, a validation message, Claim Ids cannot contain Alphabets or any special characters other than commas. is displayed in a popup with an OK button. By default, this field is blank.
Count: After entering Claim IDs in a row, the Count field automatically computes the count of Claims. By default, 0 is shown in this field.

Note: A validation message, Cannot Assign the Claim due to following reasons: Clinic is not selected. Claim is not selected. (at least 1 Claim id is must for assignment) External Id is missing for Biller. is displayed in a popup with an OK button in the following conditions:

When user selects Source, Action Required, Expected Date, Associate enters Claim IDs and clicks on the SUBMIT button without selecting Clinic.
When user selects Source, Action Required, Expected Date, Clinic, Associate and clicks on the SUBMIT button without entering Claim IDs.
When user selects Source, Action Required, Expected Date, Clinic, enters Claim IDs and clicks on the SUBMIT button without selecting an Associate or the selected Associate has blank External Id field on the Billing Staff Master screen.

Summary

The Summary section on the Centralized Claim Assignment popup sums up the Claim Assignment into two tables.

First Table under Summary: This table shows Clinic wise Claim Count. The columns in this table are Clinic and Count. On selecting a Clinic and entering Claim IDs in a row of the Claim Assignment Table, the first table under Summary section displays the Clinic and Count. The Total Claim Count for all such Clinics is auto computed and displayed at the bottom of the first table. By default, the table is blank and Total Count is 0.

Second Table under Summary: This table shows Associate wise Claim Count. The columns in this table are Associate and Count. On selecting an Associate and entering Claim IDs in a row of the Claim Assignment Table then the second table under Summary section displays the Associate and Count. The Total Claim Count for all such Associates is auto computed and displayed at the bottom of the second table. By default, the table is blank and Total Count is 0.

Action Buttons:

SUBMIT: Click the SUBMIT button, to submit and close the Centralized Claim Assignment popup.

CANCEL: Click the CANCEL button, to close the Centralized Claim Assignment popup without saving and submitting Claim Assignment.