| Topics | Search: |
|
Introduction: For better tracking of claims and generating End of the Day Reports and End of the Day closure, Batch numbers are recommended in PrognoCIS. There are 2 types of Batches, Claims Entry Batch used on Claims and Receipts Batch used on all payment posting transactions. This document will focus primarily on ‘Claims Entry Batch’. Pre-requisite for Using Claims Entry Batch Feature Following Properties govern the Claims Entry Batch behavior:
Note: Once Claims Entry Batch Property use.claims.entry.batch is set to Y, it becomes mandatory to assign Batch number to each Claim. Batch Number: It is auto generated number by system. The prefix and length of the batch number can set using properties billing.entrybatch.prefix and billing.entrybatch.length.Location Code: Select the location from the drop down list. The lists of location displayed in drop down is populated from the location master. By default, ‘All’ option is displayed. No of Claims: Enter the Number of claims to be associated to the batch. No of Charge Lines: Enter the no of charge codes to be associated to the Batch. CoPay Amount: Enter the Copay Amount. Charge Amount: Enter the Charge Amount. Batch Creation Date: By default, system displays todays date as the Batch Creation Date. User can also modify the batch creation date with backdated and click save button. Assigned To: Using the Search Assign To search icon the selected user can be assigned to batch. Close Date: Select the date from the calendar icon to close the created batch. Note: • When the batch is closed, the batch no cannot be associated or changed for the Billed and Reopen Claims. • Once the batch is closed, the batch no cannot be associated with any other Claim or newly created Claim. The Claim batch field is grayed out on Claims screen. • When a Batch is closed, any claim in ‘Ready to Send (S)’ Status with the associated Batch no is changed to ‘Ready to Bill (E)’ status. The field Batch No will get reset and enabled and Post Date also gets reset. Business Unit: Select the business unit from drop down and the selected business unit can be assigned to the batch. By default, ‘All’ option is displayed. Claims with mismatched Locations: This field displays the total count of claims with mismatched locations for the batch. Claims with mismatched Business Units: This field displays the total count of Claims with different business unit for the batch. Claims Entry Batch table: This table displays the Claim status, count and amount for all the Claims associated with the selected Batch Number. The available statuses are Entered, On Hold, Void, Ready To Send, Billed/Posted and Employer/TPA. Note: The Employer/TPA category displays the count and amount for Claims billed to Employer or Third Party Administrators (TPA). Report button on Claim Batch
screen
Clicking on the Report button,
Claims Batch Report screen is displayed. This report helps in analyzing the
vouchers associated to the Batch.
The report can be printed and exported
to excel. When
clicked, it shows the User Batch Report with list of claims unprocessed and
processed seperately with their details like DOS, Claim ID, Patient Name,
Status, Bill Amt and Modified Date.
Print -
Clicking the print button,
allows the user to print the report.
CSV -
Clicking the CSV button exports the report in CSV
format. Buttons on the screen Save: The button helps in saving the claim batch. The button gets enabled only when any change is made in the batch.Delete: This button is enabled only when a new batch is added and the batch no is not used in any voucher. Reset: Clicking on this button resets the unsaved data. Re-open: This button is enabled only when the Close Date is entered and the same voucher is not used on any voucher. |