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Insurance AR Followup Aida Anderson and Karen Lands 2010 HealthSystems Webinar Series May 25, 2010

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Page 1: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

Insurance AR FollowupAida Anderson and Karen Lands

2010 HealthSystems

Webinar Series

May 25, 2010

Page 2: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Agenda for TodayAR Reports• AR Reports� What is represented on the report?

• AR and Billing Components/Criteria• AR and Billing Components/Criteria� Use this valuable tool to review problem Financial Classes

• Billing spreadsheet/Columns/Sort• Billing spreadsheet/Columns/Sort� Manipulate columns and sort columns for quick review

• Drill down into visit• Drill down into visit� Transaction Tab

� Notes tab/Centricity Scrub

� Claims tab/Clearinghouse and Payer response� Claims tab/Clearinghouse and Payer response

HS Webinar - Slide 2

Page 3: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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A/R Defined

Accounts receivable (A/R) is one of a series of accounting transactions dealing with the billing of a customers for goods and servicesreceived by the customers. In most business entities this is typically done by generating an entities this is typically done by generating an invoice and mailing or electronicallydelivering it to the customer, who in turn delivering it to the customer, who in turn must pay it within an established timeframe called credit or payment terms called credit or payment terms

HS Webinar - Slide 3

Page 4: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

Financial Class Defined

Financial classes identify and track groupings of patients for reporting purposes. They also determine which fee schedules are used. A financial class can be Private Pay, Medicare, Medicaid, PPO, Self Pay, etc. Medicare, Medicaid, PPO, Self Pay, etc.

The Financial class associated with the primary insurance will be the financial class primary insurance will be the financial class defaulted for a patient

HS Webinar - Slide 4

Page 5: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

Entered in Registration/Insurance

HS Webinar - Slide 5

Page 6: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

F/C will be defaulted on visits created

HS Webinar - Slide 6

Page 7: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

Modifying Financial Class

FC can be changed within the visit-without

modifying Patient Registrationmodifying Patient Registration

• Work Comp

• Auto Accident• Auto Accident

• Self Pay

Financial class is locked in when batch is closedFinancial class is locked in when batch is closed

Money owed on a visit will remain in the financial class for reporting purposes, regardless of class for reporting purposes, regardless of responsibility

Page 8: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

What report shows AR by F/C?

• Aging by Financial Class– This report lists accounts receivable for patient and insurance balance totals by financial class. The totals are separated by aging category. The difference between this report and the Procedure Date Aging by Financial Class report is that this report takes all account activity (for example, balance forwards and transferred report takes all account activity (for example, balance forwards and transferred balances) into consideration when aging the balances. The Procedure Date Aging by Financial Class report ages based on the Date of Service/Date of Entry of the procedures only and does not restart based on other account activity.

– This report is useful in analyzing what financial classes generate the highest percentage of accounts receivable and where those figures fall in the aging categories, which could assist in collections efforts or financial planning for your office. Specifically, this report could be used to analyze negotiated contracts with various insurance carriers according to their assigned financial class. The Aging by Financial insurance carriers according to their assigned financial class. The Aging by Financial Class report could also be used to market your practice to desired financial classes that may not be represented at the desired level within the accounts receivable.

– Note: For the ending A/R total to match the Financial Summaries, this report must be generated through the current date or by date of service. generated through the current date or by date of service.

Page 9: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

Aging by Financial Class Report

Leave options blank to view “All”view “All”

Page 10: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

Report example

Page 11: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

Accounts Receivable Criteria

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Accounts Receivable Module

Page 13: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

Billing criteria

Page 14: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

Billing Screen displays in Visit Status order

Page 15: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

Accounts Receivable or Billing??The choice is yours!

Accounts Receivable

�New Visits not displayed

Billing

�All visit statuses available

�Transactions viewed from spreadsheet

�Must drill into Patient

�Must drill into visit to see transactions

�Statements can be printed �Must drill into Patient demographics to produce a statement

�Statements can be printed for visits selected on spreadsheet

�Must drill into visit to approve or batch a visit

�Total Panel represents

�Mass approvals and batching can be done

�Total Panel represents �Total Panel represents selected Patient Total

�Total Panel represents Spreadsheet Total

Page 16: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

Visit Status is the key to follow up!

All of the following are included in the Ins A/R report• In Progress

• Approved• Approved

• Approved Failed

• Batched• Batched

• Filed

• Sent• Sent

• File Succeeded

• File Rejected

• Collections

• User Assigned statuses

Page 17: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

Visit Status: IN PROGRESS

The Visit status flips to IN flips to IN

PROGRESS aftercharge entry,

copay posting, or copay posting, or changing the data when it’s NEW.

Page 18: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Caution Ahead: Things to Remember

IN PROGRESS-

�A Visit can transition to a status of IN PROGRESS�A Visit can transition to a status of IN PROGRESSby an accidental opening of the Visit in the Billing component and clicking OK.

�When a Visit transitions to IN PROGRESS, it separates itself from automatically updating if any changes are made to Patient Information.changes are made to Patient Information.

Page 19: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

Visit Status: APPROVED�The Visit has “passed” the 1st CPOPM edits the 1st CPOPM edits and the claim will be “cleanly” printed to paper or is ready for paper or is ready for the 2nd CPOPM edits, “Batching” for electronic “Batching” for electronic submission.

Page 20: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

Visit Status: APPROVE FAILED

�The Visit can fail the 1st CPOPM internal edits. These edits are system based and edits. These edits are system based and check to see that a paper claim can be “cleanly” generated. The edits do not check clinical appropriateness (i.e., Dx, CPT clinical appropriateness (i.e., Dx, CPT accuracy). A Visit can fail due to one or all of the following general reasons:

�Patient Information Errors�Patient Information Errors

�Charge Entry Errors

�Administrative Setup Errors

The “Notes” tab of the Visit will contain the The “Notes” tab of the Visit will contain the reasons for the failure.

Page 21: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Visit Status: APPROVE FAILED

Details of the

APPROVE FAILED

visit will appear

here.

Page 22: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Visit Status: FILED�The Visit has been printed to paper to the primary, secondary, tertiary, or beyond carriers the status secondary, tertiary, or beyond carriers the status will change from Approved to Filed-Primary, Secondary, Tertiary, or Alternate. Tertiary, or Alternate. The “Claims” tab of the Visit will contain the details of the filing history.filing history.

�Filed-Secondary/Tertiary/Alt: The Visit has “crossed-over” to that carrier.to that carrier.

�The Visit is now waiting for payments and/or adjustments. adjustments.

Page 23: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Visit Status: BATCHED

This status is seen if:

� filing to a supported clearinghouse.� filing to a supported clearinghouse.

�A Visit has been successfully prepared (passed 1st and 2nd Centricity edits) and “batched” in a file for and 2nd Centricity edits) and “batched” in a file for submission to the clearinghouse

Page 24: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Visit Status: FILED REJECTED (Internal)

This status can have 2 different definitions: Internal & External

File Rejected – Internal: File Rejected – Internal: This status indicates that the Visit has failed the 2nd CPOPM edits as it attempts to “cleanly” prepare the Visit for electronic submission. These edits are system based and organizes These edits are system based and organizes the data for electronic filing to the clearinghouse. The edit does not check clinical appropriateness (i.e., Dx, CPT accuracy). A Visit can reject due to 1 or all of accuracy). A Visit can reject due to 1 or all of the following general reasons:

�Patient Information Errors�Charge Entry Errors �Administrative Setup Errors �Administrative Setup Errors The “Notes” tab of the Visit will contain the reasons for the failure.

Page 25: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Visit Status: SENT

Indicates that a claim has been transmitted but reports have not been received.

It is possible these claims NEVER reached the clearinghouse

Page 26: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Visit Status: FILED SUCCEEDED

�Claim has passed Clearinghouse editsClearinghouse edits

�Claim passed �Claim passed Intermediary or Payer edits

Page 27: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Visit Status: FILED REJECTED (External)

File Rejected – External: If using a Supported Clearinghouse AND if the Payer’s Reports are capable of being Reports are capable of being processed by CPOPM, the Visit will be rejected whenK

� it does not meet the clearinghouse’s electronic “clean clearinghouse’s electronic “clean claim” edits

AND / OR� it does not meet the payer’s � it does not meet the payer’s electronic “clean claim” edits

The rejection details are located on the “Claims” tab of the Visit or on the “Claims” tab of the Visit or within an EDI Report

Page 28: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Visit Status: WAITING PATIENT PAYMENT

�The Visit status will transition to Waiting Patient Payment when the entire balance (responsibility) is for the patient. In other words, insurance has paid or adjusted off their other words, insurance has paid or adjusted off their balance.

Visit Status: COLLECTION

�Indicates that this visit has an outstanding balance and been placed in collections.

Page 29: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Visit Status: OVERPAID

�The Visit status will transition to OVERPAID when all payments to the Visit have exceeded TOTAL Visit balance.

Visit Status: BALANCE FORWARD

�A Visit status of BALANCE FORWARD is achieved when the Balance Forward component is utilized to “bring over” a credit or debit balance

into CPOPM from an outside product or process.into CPOPM from an outside product or process.

Page 30: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Visit Status: REFILE, REFUND, HOLD

�These are manually transitioned, user-transitioned, user-defined Visit statuses that are typically used according to office according to office policy and procedure. Sometimes they are Sometimes they are used in conjunction with the Visit Owner feature. the Visit Owner feature.

Page 31: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Work visit statuses regularlyWork visit statuses regularly

Page 32: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Customize Billing Screen view-User Based

You can control how the columns display on the Accounts Receivable window. Accounts Receivable window.

Specifically, you can hide columns so that they do not display.

You also can adjust the width of each column independently.

Page 33: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Billing Screen-adjust columns Step 1-Right Click in Title Step 1-Right Click in Title

Page 34: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Step 2-Select Columns to view

Page 35: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Step 3-Arrange order of Visible Columns

Page 36: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Adjust Column Width

To manually resize a column, place the pointer between the columns you want to resize. The pointer changes to a double-arrow which allows you to manually resize either the double-arrow which allows you to manually resize either the column to the left or right of the pointer .

Page 37: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Right Click on Header to save/sort

Page 38: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Drill into Visit-Transaction Tab

Page 39: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Drill into visit-Notes Tab

System generated rejections are

displayed in the notes tab

Examples• Insured ID Missing

• COB information not balanced• COB information not balanced

• Assignment of Benefits not complete

• Referring Physician required

Correction needs to be made• Patient Demographics

• Within the visit• Within the visit

• Administration

Page 40: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Correspondence Tab

• Click Add to Enter note note

• Note is date stamped with stamped with User name

• Cannot be • Cannot be deleted or modified

• Can be printed

Page 41: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Claims Tab

Page 42: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Claims Tab-Upper List Panel

• File Name: The name of the file (only applies to electronically filed claims).

• Filing Method: The name of the filing method.

• Filing Type: The filing type; either Electronic or Paper.• Filing Type: The filing type; either Electronic or Paper.

• Clearinghouse: The clearinghouse to which the file was sent (only applies to electronically filed claims).

• Filed By: The user who filed the claim.• Filed By: The user who filed the claim.

• Filed To: The insurance carrier to which the claim was filed.

• Submission #: A number that uniquely identifies a claim (only applies to electronically filed claims).

• Created By: The user who created the file.

• Date Created: The date the claim was created (only applies to electronically filed claims).

• Procedures Filed: A comma separated list of procedure codes (not CPT Codes) that were filed.

• Amount Filed: The total amount filed.

Page 43: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Claims tab overview-Paper claims

Page 44: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Claims Tab overview-electronic claims

Page 45: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Claims Tab Lower List Box

Displays a list of all report files that have been

generated related to the visitgenerated related to the visit

• Date Received: The date the report file was received from the clearinghouse.

• File Name: the name of the report file.

• DescriptionLists: the visit's claim results.• DescriptionLists: the visit's claim results.

Double Clicking a report file launches a notes

editor, showing the contents of the Description

Field

Page 46: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Claims Tab overview-electronic claims

Page 47: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Double clicking on the report will open the response

Page 48: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Clearinghouse Edits update status

• File Succeeded-File Rejected– If the ticket passes the clearinghouse edits an electronic message is returned that updates the visit status to “File Succeeded”returned that updates the visit status to “File Succeeded”

– Clearinghouse may have payer specific edits by payer

– If the ticket does not pass the clearinghouse edits an electronic –

message is returned that updates visit status to “File Rejected”

Payer Responses update statusPayer Responses update status• File Rejected

Page 49: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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EDI Reports from CEDI

• The reports from Centricity EDI Clearinghouse will • The reports from Centricity EDI Clearinghouse will automatically Process and automatically Archive and will display the information contained in the reports on the Claims tab of each visit. The report filename structure is: Claims tab of each visit. The report filename structure is: IDXRPTIDXRPT########.rpt.

• The reports will update visit statuses to Filed Succeeded or Filed Rejected accordingly.Filed Rejected accordingly.

Page 50: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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EDI Reports from McKesson-aka RelayHealth

• 08_082004– Transmission Report– Auto Archives– Transmission to the Clearinghouse was successful or not– Transmission to the Clearinghouse was successful or not

• XA_082004 and XS_082004– Technical Edit– Auto Processes and Auto Archives– McKesson applies technical edits to the FORMAT of your file, i.e. checking for punctuation,

etcKThe results of this report are stored on the Claims tab of each visit. etcKThe results of this report are stored on the Claims tab of each visit. – If visit was accepted, visit status is changed to File Succeeded. If rejected, visit status is changed

to File Rejected

• CA_082004– Claims Acknowledgement – Claims Acknowledgement – Auto Processes and Auto Archives– McKesson reporting whether or not they will accept each claim, after applying payer edits. The

results of this report are stored on the Claims Tab of each visit.– If visit was accepted, visit status is changed to File Succeeded. If rejected, visit status is changed

to File Rejectedto File Rejected

• EC_082004– Excluded Claims Report– Auto Processes and Auto Archives– For the claims that excluded in the CA report. This report will list the REASON for the Rejection.

The results of this report are stored on the Claims tab of each visit.The results of this report are stored on the Claims tab of each visit.– The visit status is changed to File Rejected

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EDI reports from McKesson cont.

• SF Report– Payer Report

– Auto Processes and Auto Archives

– Payer Response

– Will update visit status to “File Rejected” if Payer rejects– Will update visit status to “File Rejected” if Payer rejects

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Unable to interpret the denial?

• CEDI gives clear explanation plus gives added advantage of the CEDI dashboardadvantage of the CEDI dashboard

• McKesson may be more difficult

www.wpc-edi.com is an excellent resource-add the link to your favorites!

Page 53: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Washington Publishing Co. website

www.wpc-edi.com

Click here for Code Lists53

Click here for Code Lists

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Claim status codes

Select Claim Status Codes

54

Select Claim Status Codes

Page 55: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Claim status codes

Select List for List for review

55

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Payer Responses-What to expect!

Electronic Claims

• Initial response from clearinghouse within hours

• Acceptance/Rejection from Payer 24-48 hours

• Payment 7 days• Payment 7 days

• Visit updated automatically

Paper Claims

• Rejections received within 14 days-via mail • Rejections received within 14 days-via mail

• Payment 14 days

• Manually review and document within Centricity• Manually review and document within Centricity

Page 57: Insurance AR Followup - HealthSystemshealthsystems.net/docs/HS_Ins_AR_Follow_Up_II_05252010.pdf · Insurance AR Followup ... •AR Reports What is represented on the report? •AR

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Questions and Answers

Thank you for attending!

Aida and Karen

We value your feedback

HS Webinar - Slide 57