Assigned Tasks
Assigned Date From: Users are expected to select the Assignment From date from the calendar icon which is based on Assigned From Date. Clicking on the Clear hyperlink, users can remove the selected filter from the popup.
Assigned Date Upto: Users are expected to select the Assignment date upto from the calendar icon. Clicking on the Clear hyperlink, users can remove the selected filter from the popup.
Expected Date From: This filter when used, would Filter Claims where expected date on assignment is on or after the selected date from the calendar icon. Clicking on the Clear hyperlink, users can remove the selected filter from the popup.
Expected Date Upto: This filter when used, would Filter Claims where expected date on assignment is on or before the selected date from the calendar icon. Clicking on the Clear hyperlink, the selected filter is removed from the popup.
Assignment Type: Users are expected to Select the type of Assignment to filter assigned tasks. The values available in the drop down are Claims and Clinic. Clinic Level Assignments are assignments added from Assigned Tasks screen whereas Claim Level Assignments are assignments added from Assign To icon.
Assigned To: Users are expected to select the Assigned To User Name from the search icon. Clicking on the search icon, Assigned Medics popup is invoked. The Assigned Medics popup displays medics with the following types Biller - BL, Doctor -DR, ST - Office Staff, RN- Clinical Staff, MA- Medical Assistant. Using the Clear hyperlink, users can remove the selected Assigned To field.
Assigned Status: This field filters Assigned Status depending on task assigned or action taken. Clicking on the Search icon, Assigned Status Search popup is invoked. The values displayed in the Assigned Status popup are invoked from Settings → Configuration → Group Types → AS – Assignment Done Status. Using the Clear hyperlink, users can remove the selected Assigned Status value.
Assigned Status Not In: This field filters Assigned Status depending on task assigned or action taken which are to be excluded. Clicking on the Search icon, Assigned Status Search popup is invoked. The values displayed in the Assigned Status popup are invoked from Settings → Configuration → Group Types → AS – Assignment Done Status. Using the Clear hyperlink, users can remove the selected Assigned Status value.
Assigned By: This field displays a list of users who have assigned a task. Clicking on the search icon, Assigned Medics popup is invoked. The Assigned Medics popup displays medics with the following types Biller - BL, Doctor -DR, ST - Office Staff, RN- Clinical Staff, MA- Medical Assistant. Using the Clear hyperlink, users can remove the selected Assigned by field.
Source: This field displays a list of sources by which task is assigned. Clicking on the search icon, Source Code popup is displayed. The values displayed in the Source Code popup are invoked from Settings → Configuration → Group Types → AF - Assignment Source. Using the Clear hyperlink, users can remove the selected Assigned by field.
Source Not In: This field displays the list of sources to be excluded from where a task is assigned. Using the Clear hyperlink, users can remove the selected Assigned by field.
Action Required: This field filter Claims on which action required is the same as value selected from dropdown. Clicking on the search icon, Action Required popup is displayed. The values displayed in the Action Required popup are invoked from Settings → Configuration → Group Types → AA - Assignment Action Required. Users are expected to select the Action required. Using the Clear hyperlink, users can remove the selected Assigned by field.
Action Required Not In: This field filter Claims which are to be excluded on which action required is the same as value selected from dropdown. Clicking on the search icon, Action Required popup is displayed. The values displayed in the Action Required popup are invoked from Settings → Configuration → Group Types → AA - Assignment Action Required. Using the Clear hyperlink, users can remove the selected Assigned by field.
Assigned To Role: Clicking on the search icon, Assign To Roles popup is displayed. The values displayed in the popup are invoked from the Role master screen where the Assign To checkbox is checked for the respective Role. Users are expected to select the Role from the popup.
Assigned To Role Not In: Clicking on the search icon, Assign To Roles popup is displayed. The values displayed in the popup are invoked from the Role master screen where the Assign To checkbox is checked for the respective Role. Users are expected to select the Role which is to be excluded in the report.
Assigned To User Designation: Clicking on the search icon, Assigned Designation popup is invoked. Users are expected to select the user’s designation from the popup.
Done Status: This field filter Claims with checkbox Done checked, not checked or both on Assign To popup ico. Users are expected to select the value from the dropdown and accordingly it is displayed in the report.
Completion Date From: This field filter Claims where the Assignment completion date is based on Done date which is available on Assign To popup. Users are expected to select the completed date from the calendar icon.
Completion Date Upto: This field filter Claims where the Assignment completion date is based on Done date which is available on Assign To popup. Users are expected to select the completed date upto from the calendar icon.
Action Taken: This field filter Claims on which selected action is taken on assignment. Clicking on the search icon, Action Taken popup. The values displayed in the popup are invoked from the Settings → Configuration → Group Types → Assignment Action Taken - AK.
Action Taken Not In: This field filter Claims to be excluded on which selected Action is taken based on Assignment. Clicking on the search icon, Action Taken popup. The values displayed in the popup are invoked from the Settings → Configuration → Group Types → Assignment Action Taken - AK.
Action Status: This field filter Claims based on the Action Status which is the same as value selected from dropdown on Assign To popup. Clicking on the search icon, Action Taken popup is displayed. The values displayed in the popup are invoked from the Settings → Configuration → Group Types → Action Status - AK.
Action Status Not In: This field filter Claims which are to be excluded on which Action Status is the same as value selected from dropdown.
Action Date From: This field filter Claims where Assignment action is taken on or after this date.
Action Date Upto: This field Filter Claims where Assignment action is taken on or before this date.
Assigned To Followup Date From: Users are expected to select the Assigned To Follow Up Date From from the calendar icon.
Assigned To Followup Date Upto: Users are expected to select the Assigned To Follow Up Date Upto from the calendar icon.
Modified Date From: These are the Claims where the Assignment was modified on or after this date.
Modified Date Upto: Claims where Assignment was modified on or before this date.
Assignment F/U Due in Next X Days: Users are expected to select no. of days from current date to filter out the claims where followup is due. For e.g. if today is 01/01/2020 and User defines 3 as the number then all claims where assignment follow up is due till 04/01/2020are displayed to the users.
Assignment Due in Next X Days: Users are expected to select no. of days from current date to filter out the claims where assignments are due . For e.g. if today is 01/01/2020 and User defines 3 as the number then all claims where assignment Exp Date is due till 04/01/2020 are displayed to the users.
Assignment Done date in Last X days: Select No. of days from current date to filter out the claims with Done assignments . For e.g. if today is 01/01/2020 and the user defines 3 as the number then all claims where assignments are marked as Done from 12/27/2020 till today are displayed to the users.
Open Assignment on Claim Bal with: Users are expected to select the Open assignments with balance pending with Either Primary/Secondary/Tertiary/Employer/Patient.
Closed Assignment on Claim Bal with: Users are expected to select the Closed assignments with balance pending with Either Primary/Secondary/Tertiary/Employer/Patient.
Assignment Status on Zero Bal Claims: Users are expected to select the claims with zero balance where assignment is still kept open.
Assignment Status on Unbilled Claims: Select the claims where assignments are open and claims are not billed.
Assignment Status on Billed Claims: Select the claims where assignments are marked as Done and claims are not billed.
Note: Assignment on Claims section is only available on the Assigned Tasks screen. Charge Fields Charge Codes: This field displays a list of Claims where charge codes can be selected from this search icon. Clicking on the search icon, Charge Codes popup is invoked. Users are expected to select the charge code and click on the APPLY button to view the filter.
Charge Codes Not In: This field list the Claims which are to be excluded from where the charge codes are selected from this Search icon.
Charge Category: Clicking on the search icon, Charge Category popup is invoked. Users are expected to select the Charge Category from the popup and click on the OK button. The selected category is displayed in the Charge Category field. Clicking on the button, the previously selected Charge Category is removed.
Charge Category Not In: Clicking on the search icon, Charge Category popup is invoked. Users can select the Charge Category associated with Charge Codes, which are to be excluded from reports. Clicking on the X button on the Ad-Hoc Filter popup, the previously selected Charge Category is removed.
Charge User Category: Clicking on the search icon, Charge User Category popup is invoked. Users can select the Charge User Category associated with Charge Codes. Clicking on the X button on the Ad-Hoc Filter popup, the previously selected Charge Category is removed.
Charge User Category Not In: Clicking on the search icon, Charge User Category popup is invoked. Users can select the Charge User Category associated with Charge Codes, which are to be excluded from reports.
Combo Charge codes: Users can enter a combination of Claims with ALL specified Charge codes in this field and apply filters to view the report.
Charge Codes in a Range: Users can specify comma separated charge code ranges for e.g. 99201-99205, 99211-99215.
Charge Codes not in a Range: Users can specify comma separated charge code ranges to be excluded for e.g. 99201-99205, 99211-99215.
With Denial Category: Clicking on the search icon, Denial Category popup is invoked. Users can select the defined denied category for the denials posted. Clicking on the X button on the Ad-Hoc Filter popup, the selected denied category gets removed. Clicking on the Clear hyperlink, the selected filter is removed from the popup.
With Denial Category Not In: Clicking on the search icon, Denial Category popup is invoked. Users can select the defined denied category for the denials posted which are to be excluded in the report. Clicking on the X button on the Ad-Hoc Filter popup, the selected denied category gets removed. Clicking on the Clear hyperlink, the selected filter is removed from the popup.
Charges Outstanding with Insurance: This field displays a list where the charge code responsibility is with Insurance. This field is provided with a value Yes in dropdown.
Charges Outstanding with Patient: This field displays a list where the charge code responsibility is with Patient. This field is provided with a value Yes in dropdown.
EOB Charge Code with: This field displays a list of claims where EOB charge code has action same as value selected from dropdown. The dropdown has the following values Denied - No Action, Retain Responsibility, Disputed Contract Amt, Unapplied- Ins Charge, On Hold- By User, Recouped, Statement Comments, Normal, Additional and Duplicate.
With Denial Reason in EOB As: This field displays a list to show all charge codes with EOB posted as Denied and this Denied Reason is associated. Clicking on the search icon, EOB Denial Reason popup is displayed. Users can select the denial reason code from the popup and apply filters.
UB04 Procedure Code: Clicking on the search icon, Procedure Code popup is displayed. The Procedure Code associated with revenue code on UB04 Claim is displayed.
Mark Void checkbox checked: User can mark Void checkbox checked to view the report. This field is provided with a dropdown having value Yes.
Codes marked Procedure: This field list of CPTs marked as Procedure on CPT master and used in Claims.
Note:
This field is available on the Claims → Processed → By Charges screen. Charge Type CHISR: Users are expected to select one alphabet from CHISR to filter CPT, HCPC, ITEMS, SPL Charges, Revenue Codes respectively.
Note:
This field is available on the Claims → Processed → By Charges screen. Charge From Date: Users are expected to select the DOS this charge code when it is Billed From.
Charge Upto Date: Users are expected to select the DOS this charge code when it is Billed Upto.
Note:
Charge From Date and Charge
Upto Date fields are available on the Claims → Processed → By Charges screen NDC present for Charge: This field displays the charge code where the NDC checkbox is checked for the charge code on the Claim.
NOC present for Charge: This field displays the charge code where the NOC checkbox is checked for the chare code on the Claim.
Charge Comments: These are the charge comments mentioned for the respective charge code on the Claims screen.
Claim Fields
Creation Batch #: This field searches for the Vouchers where the entered Batch number is used. Users are expected to enter the batch no for searching.
Claim Id From: Enter the Claim From from where you want to search for in this field.
Claim Id Upto: Enter the Claim Upto where you want to search for in this field.
Date of Service From: Select the date of service of the claim you want to search from the calendar icon for in this field.
Date of Service Upto: Enter the date of service of the claim till where you want to search from the calendar icon in this field.
Send Date From: Select the Claim’s Send Date from the calendar icon. For Secondary or Tertiary, it considers Secondary or Tertiary Claim sent date.
Send Date Upto: For Secondary or Tertiary, it considers Secondary or Tertiary Claim sent date.
Claim Creation Date From: Users can select the Claim Creation Date From from the calendar icon for this field.
Claim Creation Date Upto: Users can select the Claim Creation Upto date from the calendar icon for this field.
Claim Send Mode CMS/EDI: Users can select the option CMS for filtering Paper Claims, keyword EDI to filter Claims sent Electronically from the dropdown. Claim Financial Class Code: Users can select code of Financial Class associated with Claim. Clicking on the search icon, the Financial Class popup is displayed. The values displayed in the popup are invoked from Settings → Configuration → Group types → Financial Class- B3.
Claim Financial Class Code Not In: Users can select the Code of Financial Class associated with Claim which are to be excluded from the report.
Rendering Doc Name: Users can select Rendering Provider Name which is associated with the Claim. Clicking on the search icon, Medics popup is invoked. The medics type displayed in the popup are of type DR and ZE.
Rendering Doc Name Not In: Users can select Rendering Provider Name associated with Claim which are to be excluded from the report.Clicking on the search icon, Medics popup is invoked. The medics type displayed in the popup are of type DR and ZE.
Attending Doc Name: Users can select Attending Doctor Name associated with Claim to display in the report. Clicking on the search icon, Medics popup is invoked. The medics type displayed in the popup is of type DR.
Attending Doc Name Not In: Clicking on the search icon, Medics popup is invoked. The medics type displayed in the popup is of type DR.Users can select Attending Doctor Name associated with Claim which are to be excluded from the report.
Location: Clicking on the search icon, location master popup is displayed. Users are expected to select the code for Location used in Claims.
Location Not In: Users are expected to select code for Location used in Claims which are to be excluded from report. Clicking on the search icon, location master popup is displayed.
Business Unit: Clicking on the search icon, business master popup is displayed. Users are expected to select code for Business code used in Claims.
Business Unit Not In: Clicking on the search icon, business master popup is displayed. Users are expected to select code for Business code used in Claims which are to be excluded in the report.
POS Code: Clicking on the search icon, Place of Service popup is displayed. Users are expected to select the Place of Service used in Claims. The values displayed in the popup are invoked from Settings → Configuration → Group Types → B5 - Place of Service.
TOS Code: Clicking on the search icon, Type of Service popup is displayed. Users are expected to select the Type of service code which is invoked from Encounter Type master. The values displayed in the popup are invoked from Settings → Configuration → Group Types → B4 - Type of Service.
Claim Encounter Type: Clicking on the search icon, Encounter Type popup is displayed. The values displayed in the popup are from the Encounter Type master.
Claim Encounter Type Not In: Clicking on the search icon, Encounter Type popup is displayed. The values displayed in the popup are from the Encounter Type master. Users can select the Claim Encounter which is to be excluded from the report.
Self Pay Claim: This field displays the Claims which are directly billed to patients. Users are expected to select the option Yes to display the Claims directly billed to Patients.
Claim Status EHSVB: Clicking on the Search icon, Claim Status EHSVB Search list gets invoked. The values displayed in the Search list are Entered, On Hold, Ready to Send, Void, Billed. Select appropriate value/s from the Search list. Using the Clear hyperlink, users can remove all the selected Claim Statuses from the filter. The default value in this field is blank.
EDI batch #: Users are expected to enter the Claims Edi Batch no where it is the same as the value entered in the field.
Note: This field is not available on Unprocessed screen.Track Status #: Users are expected to enter a comma separated list of Track Status numbers. The valid track status is shown on the Legend button of the Outstanding Claims screen.
Note: This field is not available on Unprocessed screen.Track Status Nos Not in: Users are expected to enter a comma separated list of Track Status which are to be excluded from the report. The valid track status is shown on the Legend button of the Outstanding Claims screen.
Note: This field is not available on Unprocessed screen.Case No: Enter the case no field to Filter out the claims having case number which is same as in the Case No Field.
Case Employer Name: Enter the case employer name which would list the Claims/Charge codes where a Case is associated with the Employer Name starting with the entered value.
Claims from EMR: This field filter claims created from EMR or from Billing. This field is provided with a drop down with two values: EMR - Encounter Close and Billing - Claim New. Users are expected to select any of the values to filter the claims.
Claims Insurance Type: This field lists the Claims with checkbox Work Comp Employment, Auto Accident, Other Accident checked on Claims screen. The values available in the drop down are Work Comp, Auto Accident, Personal Accident, Any Accident, Non Accident, Capitation and DMERC.
Professional/Institutional claims: This field list professional (CMS1500) claim/ List of Institutional (UB04) claims. This field is provided with a drop down and values available in the drop down are Professional and Institutional. Depending on the value, the claims are filtered out.
Claim / Penalty Invoice: This field is used to Filter only Claims or only Penalty Invoices. The values available in the drop down are Claims Only and Penalty Invoice Only.
Collection Agency: This field displays a list of collection agencies defined in PrognoCIS. The list of collection agencies displayed in the drop down is invoked from Settings → Configuration → Collection Agency master.
Col Agency Handover Date From: Users are expected to select the Col Agency Handover Date from the calendar icon.
Col Agency Handover Date Upto: Users are expected to select the Col Agency Handover Upto from the calendar icon.
Note:
The fields Collection Agency, Col Agency Handover Date From and Col Agency
Handover Date Upto are not available on Unprocessed and Returned/Rejected
screen under Billing Filters screen.
ICD10 Codes: The ICD 10 Codes field supports mix of codes and range is supported along with comma separated values. This field character limit is increased from 30 to 100. Example: Users can enter a range of charge code like 99212-99215 in the ICD 10 Codes field.
ICD10 Codes Not In: This filter enables the users to filter the claims where selected ICD codes or ranges which are not used are filtered. For e.g.: When user defines following combinations – S89.90XA - S90.936A, S99.001A - S99.229A, V36.0XXA-V36.9XXS. Any of the claims with any of the codes defined in the range or comma-separated values are filtered out and excluded from results while the list and report are displayed to the users. The count of characters supported is increased from 30 to 100 so that users can accommodate more ICD codes for filtering the data.
Eligibility Status: This dropdown enables the user to filter Claims as per Eligibility Status. Select the preferred value as Active or Not Active from the dropdown. The default value in this dropdown is blank.
Note: Not Active Eligibility Status also includes Not Fetched, Not Retrieved, Inactive, Blank, Other Statuses.
Snomed Codes: Users are expected to enter Comma separated Snomed Codes that can contain 1 value or multiple values in this field.
ICD 9 or 10 Claims: Users are expected to select ICD9 or ICD10 Claims from the dropdown.
Employer Claims: This field is provided with a drop down having values Yes and No. On selecting the value Yes from the drop down, it lists the claims whose responsibility is with Employer.
Job No: Users are expected to enter Job No in the field to filter the claims where the Job No entered is the same.
Tpa Name: Users are expected to enter TPA Name in the field to filter the claims where the TPA Name entered is the same.
Patient Employer Name: This field lists the Claims/Charge codes where Patients associated Employer Name is starting with entered value.
Cell 10D: Users are expected to enter comma separated Claim Codes from the Claims I button field.
DCN ICN No#: Users are expected to enter the DCN ICN no to filter only those claims where the DCN ICN no entered is the same.
24H EPSDT checkbox checked: This field lists the Claims where the 24H EPSDT checkbox checked on CMS Flag popup. On selecting this filter, the system filters out the claims where the 24H EPSDT checkbox is checked.
Attorney Claims: Users are expected to select a value drop down. The values provided in the drop down are Yes and No. On selecting the Yes option, system filter out Attorney Claims.
Insurance Professional Payer ID: Users are expected to enter the same Professional Payer Id field which is entered for Prof Payor ID on Insurance master screen.
Insurance Institutional Payer ID: Users are expected to enter the same Institutional Payer Id field which is entered for UB04 Inst Payor ID on Insurance master screen.
Primary Subscriber ID: This field filters Claims which have Primary Insurance Subscriber ID like the value entered.
Secondary Subscriber ID: This field filters Claims which have Secondary Insurance Subscriber ID like the value entered.
Tertiary Subscriber ID: This field filters Claims which have Tertiary Insurance Subscriber ID like the value entered.
Claim Comments Y/N: This dropdown enables the user to select only those Claims having Claim Notes. Select the preferred value as Yes or No from the dropdown.The default value in this dropdown is blank.
Rejected Claims Y/N: This dropdown enables the user to filter the claims that are under rejections queue and are not resubmitted yet. Select the preferred value as Yes or No from the dropdown. The default value in this dropdown is blank.
Reopened Claims Y/N: This dropdown enables the user to filter the claims which are reopened and not yet billed. Select the preferred value as Yes or No from the dropdown. The default value in this dropdown is blank.
Claim Hold Reason: On clicking the search icon, Claims Hold Reason popup is invoked. On selecting checkboxes for preferred Claim Hold Reason and clicking on OK, the marked reasons get populated in the field. Maximum 10 checkboxes can be selected in this popup. Clicking on the X button removes a Claim Hold Reason that a user might not want in the field. Clicking on the Clear hyperlink removes all the entries made in this field.
Claims with No EDI response - Y: This dropdown enables the user to select claims which are billed electronically with no EDI response. Select the preferred value as Yes or No from the dropdown. The default value in this dropdown is blank.
Claim Creation Days: This field is capable of filtering all claims which are created before X no of days.
Last EOB Post Date From: This field displays only those claims where Insurance EOB is posted for such accounts for the selected from date.
Last EOB Post Date Upto: This field displays only those claims where Insurance EOB is posted for such accounts for the selected upto date.
TPA Claims Y/N: This filter field helps to identify which claims are billed to TPA. This field is provided with a dropdown having two Yes and No options. When the user selects Yes option, the report filters out all the claims billed to TPA. When the user selects the No option; the report filters all the claims except the ones billed to TPA are displayed.
Employer TPA Invoice Number: This field is provided with a multiselect having a search icon and clear hyperlink. This field lists the Employer claims with the selected Invoice Number. Clicking on the Search icon, the Employer Invoice popup is invoked. This popup lists all employer invoices and TPA invoices. Clicking on the Clear hyperlink, deselect the value from the field. User can select 30 values to filter out the data.
Claims with Eligibility Reviewed: This dropdown enables the user to filter the claims which are reviewed for Eligibility. Select the value as Yes or No from the dropdown. Filtering with the value selected as Yes displays all such claims which have been reviewed for eligibility whereas filtering with the value selected as No displays all such claims which have not been reviewed for eligibility. The default value in this dropdown is blank.
Claims with Coding Reviewed: This dropdown enables the user to filter the claims which are reviewed for Coding. Select the value as Yes or No from the dropdown. Filtering with the value selected as Yes displays all such claims which have been reviewed for coding whereas filtering with the value selected as No displays all such claims which have not been reviewed for coding. The default value in this dropdown is blank.
Claims with Errors: This dropdown enables the user to filter the claims as per errors. Select the value as Yes or No from the dropdown. Filtering with the value selected as Yes displays all such claims which have errors whereas filtering with the value selected as No displays all such claims which do not have any error. The default value in this dropdown is blank.
Claims with Warnings: This dropdown enables the user to filter the claims as per warnings. Select the value as Yes or No from the dropdown. Filtering with the value selected as Yes displays all such claims which have warnings whereas filtering with the value selected as No displays all such claims which do not have any warning. The default value in this dropdown is blank.
Claim Encounter Status: This dropdown enables the user to filter the claims as per the Encounter Status. Select the value as No Encounter, Closed or Open. The default value in this dropdown is blank.
Note: This field is also available on Processed screen.
Insurances
Insurance Name Like: Enter the keywords for insurance and clicking on APPLY button filters all the Insurances starting with those keywords.
Insurance Selection: Clicking on the search icon invokes Insurance popup. Maximum 30 Insurances can be selected from the popup. Clicking on the ╳ button present on the top right of a particular Insurance removes it from the field. The path to define Insurance is Settings → Configuration → Insurance master. Clicking on the Clear hyperlink removes all the Insurances present in this field.
Insurance Selection Not In: This filter is applied to all Insurances in the master except for those selected in this field. Clicking on the search icon invokes Insurance popup. Maximum 30 Insurances can be selected from the popup. Clicking on the X button present on the top right of a particular Insurance removes the entries from the field. Clicking on the Clear hyperlink removes all the entries made into this field.
Pri Insurance AR Code: Clicking on the search icon invokes AR Code for Primary Insurance popup. The limit for selecting Primary AR code is 30. Clicking on the ╳ button removes entry made in this field. Clicking on the Clear hyperlink removes all the Primary Insurance AR Codes present in this field. Note:- Pri Insurance AR Code and Insurance AR Code are defined from Settings → Configuration → Group Types → Insurance AR Codes.
Pri Insurance AR Code Not In: This filter is applied to all the Primary Insurance AR Codes in the master except for those added in this field. Clicking on the search icon invokes AR Codes for Primary Insurance popup. The limit for selecting Primary AR code is 30. Clicking on the X button removes an entry made in this field. Clicking on the Clear hyperlink removes all the entered Codes from this field. Note:- Pri Insurance AR Code and Insurance AR Code are defined from Settings → Configuration → Group Types → Insurance AR Codes.
Insurance AR Code: Clicking on the search icon invokes Insurance AR Code popup. Maximum 30 Insurance AR Codes can be selected from the pop. Clicking on the X button removes previously selected AR Code from this field. Clicking on the Clear hyperlink removes all the Insurance AR Codes present in this field. Note:- Pri Insurance AR Code and Insurance AR Code are defined from Settings → Configuration → Group Types → Insurance AR Codes.
Insurance AR Code Not In: This filter is applied to all Insurance AR Codes except for those present in this field. Clicking on the search icon invokes popup for Insurance AR Code . Maximum 30 Insurance AR Codes can be selected from the popup. Clicking on the X button removes previously selected AR Code from this field. Clicking on the Clear hyperlink removes all the Insurance AR Codes present in this field. Note:- Pri Insurance AR Code and Insurance AR Code are defined from Settings → Configuration → Group Types → Insurance AR Codes.
Selected Insurance As: This dropdown has the values, Primary, Secondary and Tertiary. For a selected Insurance, users can choose preferred value from the given dropdown.
Claim Primary Insurance Type In: This field is provided with multi-select having search icon and clear hyperlink. This filter helps to identify the claims which belong to a specific insurance type selected on Patient Insurance umbrella and associated with the claim as Primary Insurance. Clicking on the Search icon, Insurance Type popup is invoked. The values displayed in this popup is of type IT – Insurance Type. Clicking on the Clear hyperlink, deselects the value from the field. User can select 30 values to filter out the data.
Claim Secondary Insurance Type In: This field is provided with multi-select having search icon and clear hyperlink. This filter helps to identify the claims which belong to a specific insurance type selected on Patient Insurance umbrella and associated with the claim as Secondary Insurance. Clicking on the Search icon, Insurance Type popup is invoked. The values displayed in this popup is of type IT – Insurance Type. Clicking on the Clear hyperlink, deselects the value from the field. User can select 30 values to filter out the data.
Claim Filing Code: Clicking on the Search icon, Claim Filing Code Search list gets invoked. Users are expected to select Primary and/or Secondary Claim Filing Codes that have been used to bill the Claim to be displayed in the report. Using the Clear hyperlink, users can remove all the selected Claim Filing Codes from the filter field. The default value in this field is blank.
Claim Filing Code Not In: Clicking on the Search icon, Claim Filing Code Search list gets invoked. Users are expected to select Primary and/or Secondary Claim Filing Codes that have been used to bill the Claim to be excluded from the report. Using the Clear hyperlink, users can remove all the selected Claim Filing Codes from the filter field. The default value in this field is blank.
Note: Claim Filing Code Not In does not include the Claims that have Medicare and/or Medicaid as Primary and/or Secondary Insurance present.
Outstanding AR
Responsibility With: This field displays a list where current responsibility is with the selected value from dropdown AND any other criteria selected. This field is provided with the dropdown values Primary, Secondary, Tertiary, Employer, Patient, Pri/Sec/Ter,Pri/Sec/Ter/Pat, and Collection Agency.
Note: This field is not available on Unprocessed screen.
Payment Status: This field displays list of the Payment Status as selected from dropdown AND any other criteria selected. Option 'Fully Paid' is not available for 'Responsibility with' and 'Min Balance'.
Note: This field is not available on Unprocessed screen.
Outstanding Only: This field displays the Claims with Outstanding Amount Only. This field is provided with a value Yes in the dropdown. If the user selects the value Yes and applies filter then system populates the claims with Outstanding amount only.
Note: This field is not available on Unprocessed screen.
Min Balance: Users are expected to enter the Min balance and click on APPLY button to view the filter report.
Note: This field is not available on Unprocessed screen.Max Balance: Users are expected to enter the Max balance and click on APPLY button to view the filter report.
Note: This field is not available on Unprocessed screen.
OS Days from DOS: Users are expected to enter the OS Days from DOS and click on the APPLY button to view the filter report.
Min OS Days from DOS: Users are expected to enter the Min Days from DOS and click on the APPLY button to view the filter report.
Max OS Days from DOS: Users are expected to enter the Min Outstanding Days from DOS and click on the APPLY button to view the filter report.
Beyond Ins Response Days: This is the case when there is no Response from Insurance for No. of Days more than difference of Today's Date and DOS i.e more than Overdue days set on Insurance Master. Users are expected to select the values from the drop down and click on the APPLY button to view the filter report. The values in drop down are Primary, Secondary and Tertiary.
Aging Buckets by DOS From-Upto: Users are expected to enter the Claim Outstanding for specified From - Upto days from the Date of service. Example: Users can mention the aging bucket 60-90 in the field and and click on the APPLY button to view the filter report.
Aging Buckets by Sent DOS From-Upto: Users are expected to enter the Claim Outstanding for specified From - Upto days from the Send Date. Example: Users can mention the aging bucket 60-90 in the field and click on the APPLY button to view the filter report.
Note: This field is not available on the Unprocessed Claims screen.
Min OS Days from DOS: Users are expected to enter the Min Days from DOS and click on the APPLY button to view the filter report.
Max OS Days from DOS: Users are expected to enter the Min Outstanding Days from DOS and click on the APPLY button to view the filter report.
Pats in AR bucket by DOS: This field display list of all Claims of a Patient with atleast One Claim in AR bucket by DOS. E.g: Aging bucket 60-90 and click on the APPLY button to view the filter.
Pats in Ar bucket by Send Date: This field displays list of all Claims of a Patient with atleast One Claim in AR bucket by Send Date. E.g: Aging Bucket 60-90 and click on the APPLY button to view the filter.
Patient
Patient Chart No: Clicking on the search icon, Patient Search popup is invoked. Select checkboxes for preferred Chart Nos of patients to be considered for this report. Chart Nos for patients are allotted on the Patient Registration screen. Maximum 30 selections can be made from the popup. Clicking on the button, the selected chart no gets removed. Clicking on the Clear hyperlink, the selected filter is removed from the popup.
Patient Name Like: Enter keywords from patients’ first or last name in this field. E.g. If ‘John’ are the letters entered in this field, this filter is applied to the patients having ‘John’ in their first or last name.
Patient Last Name From: Enter alphabet or keyword for last name of the patient to be considered for From. E.g. If the alphabet ‘John’ is entered in this field, this filter is applied to the patients whose last name starts with ‘John’.
Patient Last Name Upto: Enter alphabet or keyword for last name of the patient to be considered for Upto. E.g. If the alphabet ‘David’ is entered in this field, this filter is applied to the patients whose last name ends with ‘David’.
Patient Account No like: List of patients whose Patient Account No is starting from entered value.
Employer Name: List of Claims/Charge Codes where Employer Name associated with a patient is starting with an entered value.
Patient Financial Class:Enter the value for Financial Class associated with a patient. Clicking on the search icon invokes Claim Financial Class popup. Maximum 30 selections can be made from the popup. Clicking on the button removes chart no from this field. Clicking on the Clear hyperlink removes all the entries from the field.
Patient Financial Class Not In: Enter Financial Class associated with a patient that should be excluded from the report. Clicking on the search icon invokes Claim Financial Class popup. Maximum 30 selections can be made from the popup. Clicking on the ╳ button removes chart no from the field. Clicking on the Clear hyperlink removes all the entries from the field.
Note: Financial Class is defined in Settings → Configuration → Group Types →
Financial Class.# Of statements since last payment: Enter the No. of statements which are generated for the patient after the last payment was posted against the patient account.
Patients with Advance Greater than: Enter the amount to list claims for patients where Advance Amount for that patient account is greater than amount added in the filter.
Patients with Advance Less than: Enter the amount to list claims for patients where Advance Amount for that Patient account is less than amount added in the filter.
# of Reminder Letters sent: Enter the No. of Reminder Letters which are generated for the patient after last payment was posted against patient account.
Patient Balance Greater Than: The filter is used to display all claims for the patient where total patient balance on that account is Greater than amount specified.
Patient Balance Less Than: The filter is used to Display all claims for the patient where total patient balance on that account is Less than amount specified.
Action Buttons:
SAVE AS button: Click the 'SAVE AS' button, to
save the filter.
APPLY button: Click the
'APPLY' button, it will apply the filter changes.
