Filter icon: This icon is placed at the top left corner. Clicking on the Filter icon, Filters popup is displayed. This popup contains System Defined Filters which are default saved filters as well as Independent Filters. Click on the Add New Filter icon to invoke Ad-Hoc Filter popup to customize filters that might not be a part of System Filters. These fields are configurable. An applied filter shows a green dot on the Filter icon for indication simultaneously a blue colored badge for the applied filter is also shown.
Sort: The system facilitates the sorting of Claims based on the chosen sequence in the popup. Click on the Sort button to invoke the Sort Criteria popup. Within this popup, you can select their preferred sorting option, whether in Ascending or Descending order. 
Manage Columns: Manage Columns is an additional filter which enables the user to select required columns. You can customize the columns and analyze details on the screen. After clicking on the Manage Columns icon, a selection box is displayed which has two columns - Available Columns and Selected Columns. Available Columns are the total available columns from where you can select columns to be displayed on the screen.Simply click on the arrow (→or ←) to move it either side. On clicking the right arrow →, the respective column name is added to Selected Columns. After selecting the preferred columns, click the APPLY button to save the changes made which are reflected on the screen.The Select Checkbox and Claim Id fields available under the Selected Columns are grayed out and you cannot remove these two columns from the
screen. The arrows are shown grayed out with a lighter shade which helps the users from changing the position of the fixed columns.
Print icon: It
allows printing of details of Claims displayed on the Unprocessed Claims screen. 
CSV icon: It
allows printing of the complete details on the Unprocessed Claims screen in Excel format. When the property prognocis.reportcsv.encrypteddownload is set to On, clicking on this button triggers a popup requesting the user to enter a password. The user is then able to download the data from the Unprocessed Claims screen in an Excel sheet only after entering the correct password. On the other hand, if the property prognocis.reportcsv.encrypteddownload is set to Off, the user can directly download the Excel sheet with data upon clicking the button without the need for a password.
Properties: This button is exclusively visible to users with Read Access to the Properties Master screen. Access to this button is strategically granted to enhance user functionality. Clicking the Properties button triggers a popup, presenting a list of properties from the
Properties
Master screen in PrognoCIS that cater to
Unprocessed Claims.
Select Checkbox: A Select checkbox is positioned in front of each claim ID, providing users with the ability to choose specific claims for executing various actions through the actions icon.
Claim Id: All the Unprocessed Claims are listed on the screen with their respective Claim Ids. Click the hyperlinked Claim Id to navigate to the Claim on the Edit Claims screen. Clicking on the vertical ellipsis
next to each Claim Id invokes a list which presents various icons.They are:
Patient Details: Click on this button to invoke the Patient Information popup displaying Patient’s Registration details. This popup allows you to add or update the Patient Details.
Insurance Details: Click this icon to opens the Patient Insurance popup which allows you to view and manage the patient's insurance details. You can enter insurance policy information to identify the policies the patient has subscribed to. If multiple policies exist, they can be categorized as Primary, Secondary, and Tertiary Insurance.
Claim Ledger: Click this icon to see a list of all transactions posted against the Claims. The details include Transaction Date, Document Number, Transaction Source, Billed Amount, Paid Amount, Adjustments, Copay Applied, and Denial Reasons.
Claim Letter: Click this icon to open the Claim Letter popup. Doctors or billers use this feature to send assessments and treatment plans to the referring doctor. It is also used to send letters to Patients and Insurance companies.
Claim Notes: Use this icon to add internal notes related to the Claim for documentation purposes. Once a note is added and saved, the icon displays a green tick mark. All notes are time-stamped and cannot be edited after saving.
Patient Billing Notes: Click on this icon to invoke a Patient Billing Notes popup to add, display, print or delete Patient Billing Notes.
Patient Notes: Click this icon to open the Patient Notes popup. This popup allowing users to add or view additional information related to the Patient.
Patient Alert: Click this icon to add and display patient alerts, which are essential for the front office during appointment scheduling. Alerts can also be viewed from the Encounter, Appointment, and Billing screens. Users can set an effective date range (From and Up To) for alerts. The Del checkbox enables alert deletion.
AR Calling: Click this icon to open the AR Calling Info popup, displaying details of the selected Claim. This feature helps users follow up with insurance companies or patients to resolve pending Claims, verify payment status, and ensure timely reimbursement for medical services. The displayed details include Patient Details, Claim, Primary Insurance, and Secondary Insurance. Users can print AR Calling details for reference or tracking purposes using the PRINT button.
Assign To: Click this to open the Assign To popup. This popup allows you to assign tasks to other users. This feature is used to assign tasks for a single Claim.
Patient Account: Click this icon to see a comprehensive billing summary of the Patient.
Encounter Details: Click the stethoscope icon to navigate to the Patient’s Encounter screen for the selected Claim.
Assign Status: Displays the Assign Status in this column. When the property, claim.assignstatus.as.trackstatus.name is set to On, the Track Status Value is displayed in this column. Example: If the Code column in the Track Status Notes popup displays "51 – ERA Received" then if the property, claim.assignstatus.as.trackstatus.name is set to On, the Assign Status column will display the value "ERA Received." If the property is set to Off, then Assign Status column on this screen for a Claim displays the value saved in the Action Required dropdown on the Assign To popup when Action is yet to be taken. Once the Action is taken, the Assign Status column shows the value saved in the Status dropdown of the Assign To popup. By default, this property is Off.
Assign to: Shows the name of the user to which the Claim task is assigned.
Claim Assign Date: Shows the date on which a Claim was assigned to the user.
Done Comments: Shows the Comments related to the Action completed.
Expected Date: Displays expected date of the assignment completed. The expected date cannot be less than today's date i.e., when the task is being assigned.
Follow Up Date: Displays the date for following up with the assigned task.
Claim Batch No: Displays the Claim’s or Penalty Invoice’s batch no.
Claim BU Code: Shows the Business Unit Code assigned to the Claim.
Claim BU Name: Shows the Business Unit Name corresponding to the Code.
Claim Case No: Displays the case no of the Claim in this column. The Case Nos displayed in this column are hyperlinked.
Claim Charge Codes: Shows the Charge Codes associated to the Claim.
Claim Creation Date: Displays the date when the Claim was created.
Claim DOS: Shows the date of service of the Claim.
Claim Employer Name: Displays the employer's name associated with the Claim.
Claim Enc Type: Displays the Claim’s encounter type.
Claim Enc Type Name: Displays the Name of the Claim’s encounter type.
Claim ICD10s: Shows the ICD10 Codes associated to the Claim.
Claim On Hold Reason: Displays the reason why Claim has been put On Hold.
Claim Reopened: Displays the Claim's Reopened Status with ‘Yes’ or ‘No’.
Claim Status: Shows the Status of the Claim such as E which stands for Entered or H which stands for On Hold.
Claim TPA Name: Shows the TPA associated with the Claim.
Attending Provider: Displays the name of the attending provider.
Billing Provider Type: Displays the billing provider type name in this column.
Pay to Provider Type: Displays the pay to provider type name in this column.
Balance Amount: This column displays the Claim's Balance amount.
Billed Amount: This column displays Total Billed amount of the Claim is displayed.
Copay Amount: Shows the Copay amount with the Patient.
Claim Type: Displays the type of the Claim in this column.
Claims with Errors: This field displays the no of errors the Claim has encountered. For e.g. If Claim has 3 Errors, Number 3 is displayed on the column in red color with a hyperlink. The count of error is displayed with a hyperlink. Clicking on the hyperlink, invokes all errors related to the claim as captured by PrognoCIS are displayed. Note: If there are no errors then the count is displayed as 0.
Claims with Errors/Warnings: This field displays the no. of warning and error the Claim has encountered.
Claims with Warnings: This field displays the no of warning the Claim has encountered. The count of error is displayed with a hyperlink. Clicking on the hyperlink, invokes all warning related to the claim as captured by PrognoCIS are displayed. For e.g. If Claim has 3 warning, number 3 is displayed on the column in red color with a hyperlink. Note: If there are no warning then the count is displayed as 0.
Days Count Since DOS: Display the days difference between the Claims date of service to Current Date.
Invoice Number: Shows the Penalty Invoice Number, if any.
Claim Location Code: This column displays the location code of Claims.
Claim Location Name: Shows name of the Claim Location.
Claim Pri. Eligibility Details: This field displays hyperlink with a label Claim Pri Eligibility Details. Clicking on the hyperlink invokes the HTML from Trizetto or WAYSTAR or a text message in case of other clearinghouses.
Claim Pri. Eligibility Status: Eligibility Status of the Primary Insurance is displayed. The values displayed are Active Coverage, R – Not Retrieved (Resubmit), A – Active, I – Inactive, O – Request Rejected and N – Not Requested.
Claim Pri. Subscriber ID: The subscriber ID Of the primary Insurance is displayed.
Claim Primary Insurance: Shows the Claim’s Primary Insurance.
Claim Sec. Subscriber ID: The subscriber ID Of the Secondary Insurance on claim.
Claim Sec. Eligibility Details: This field displays hyperlink with a label Claim Sec Eligibility Details. Clicking on the hyperlink invokes the HTML from Trizetto or WAYSTAR or a text message in case of other clearinghouses.
Claim Sec. Eligibility Status: Eligibility Status of the Secondary Insurance is displayed. The values displayed are Active Coverage, R – Not Retrieved (Resubmit), A – Active, I – Inactive, O – Request Rejected and N – Not Requested.
Claim Secondary Insurance: Shows the Claim’s Secondary Insurance.
Claim Ter. Insurance: Shows the Claim’s Tertiary Insurance.
Claim Ter. Subscriber ID: The subscriber ID Of the Tertiary Insurance on claim.
Patient Chart No: Displays the patient’s chart no in this column.
Patient DOB: Displays the date of the birth of the patient in this column.
Referring Provider: Displays the referring provider name in this column.
Patient Name: This column displays the name of the Patient.
Rendering Provider: This column displays the name of the Rendering Doctor associated to the Claim.
Claim Count: This displays the Total Count of Claims on the screen.
Total Charge $: This displays the Total Billed Amount of Claims on the screen.
Pagination: Pagination on the Unprocessed Claims screen helps users navigate through multiple pages of Claims efficiently.
The following options are available:
First: Takes the user to the first page of Claims in the list.
Previous: Moves the user to the previous page, displaying earlier Claims.
Next: Moves the user to the next page, showing the following set of Claims.
Last:Takes the user to the last page, displaying the final set of Claims.
