Collections / Insurance Tab
Overview
The Insurance tab contains a list of guarantor accounts in insurance responsibility that have been transferred to internal collections. Only the guarantor accounts that have active collection tasks are listed on this tab. When the account balance goes to zero, the collection task is no longer displayed.
How to Get Here?
| From the Home Page: | From the Menus: | Via Shortcut Keys: |
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(Click an image below to enlarge.)
Insurance Tab
Insurance Tab / General Sub-tab
Insurance Tab / Service Line Sub-tab
Insurance Tab / Account Notes Sub-tab
Insurance Tab / Collection Actions Sub-tab
Field Definitions
Field | Type | Required | Description |
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Filters | Filter | No | Filtering options used to specify which collection tasks are listed by guarantor account. Allows the list of collection information to be filtered by Account, Payer, and Collector. As you type, the collection information in the list is filtered to show only the data that matches what was typed. To restore the list to all collection information, clear the contents of the filters. |
Count | Read-only (system count) | Yes | Provides the number of items included in the collection tasks list. |
Practice | Display Only (pulled from Claim) | Yes | The practice associated with the collection task. |
Attachment | Read-only System generated if there is an attachment associated with the line item. | Yes | The field will display Yes or No depending on if there is an associated attachment. |
Account | Display Only (pulled from Claim) | Yes | The account number of the guarantor account. |
Case | Display Only (pulled from Claim) | Yes | The identification number of the case associated with the claim. |
Patient | Display Only (pulled from Claim) | Yes | The name of the patient. |
Facility | Display Only (pulled from Claim) | No | The name of the facility where services were rendered. |
Provider | Display Only (pulled from Claim) | Yes | The name of the billing provider for which the claim was submitted. |
Payer | Display Only (pulled from Claim) | Yes | The name of the insurance company that is financially responsible for the account. |
Plan | Display Only (pulled from Claim) | Yes | The name of the insurance plan that is financially responsible for the account. |
Eligibility Status | Display Only (pulled from Eligibility Response) | No | The status, or the state of being qualified or entitled to benefits for the selected SVFE line item.
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Rank | Display Only (pulled from Claim) | Yes | The order in which the payer has financial responsibility when there is more than one payer, for example, primary, secondary, tertiary 1, and tertiary 2. Each payer is identified by a number from 1 to 3, indicating the rank of the payer. The following numbers are used:
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DOS | Display Only (pulled from Claim) | Yes | The date of service of the procedure. |
CPT | Display Only (pulled from Claim) | Yes | The five-digit code that identifies the general procedure code/HCPCS. |
ASA | Display Only (pulled from Claim) | Yes | The five-digit code that identifies the anesthesia procedure code. |
Billed Amount | Display Only (pulled from Claim) | Yes | The total amount billed for the service line item. |
Expected Amount | Display Only (pulled from Claim) | Yes | The expected amount of payment from the responsible party for the amount billed, which is determined by the expected fee schedule configured at the practice configuration. |
Balance | Display Only (pulled from AR) | Yes | The current balance on the guarantor account. |
Last Action | Display Only (pulled from defined Collection Actions) | Yes | The action defined as Action Type in the collection action and corresponds to the last action taken in the collection effort, for example, phone call, follow-up phone call, or demand letter. |
Last Action Date | Display Only (pulled from defined Collection Actions) | Yes | The date defined as the Next Action Date in the collection action and corresponds to the last date that action was taken in the collection effort. |
Next Action | Display Only (pulled from defined Collection Actions) | Yes | The action defined as the Next Action Type in the collection action and corresponds to the next action to be taken in the collection effort. |
Next Action Date | Display Only (pulled from defined Collection Actions) | Yes | The date the next action is scheduled to occur based on the practice configuration. This date is automatically filled in based on the selection for the Next Action Type. You can accept the default date or override the date by typing or selecting another date. The year is automatically populated with the current year. |
Collector | Display Only (pulled from the Practice's Insurance Collections assignment rules) | No (either the Collector OR Collector Group will be populated) | The name of the collector to whom the task is currently assigned. |
Collector Group | Display Only (pulled from the Insurance Collections assignment rules) | No (either the Collector OR Collector Group will be populated) | The name of the collector group to which the task is currently assigned. |
Last Denial Code | Display Only (pulled from Claim) | Yes | The group and reason code for the last payment for the responsible insurance plan. (e.g., Group Code - Reason Code) |
Member Number | Display Only (pulled from Claim) | Yes | The unique number issued by the payer to identify the patient who participates in a group plan. |
Group Number | Display Only (pulled from Claim) | Yes | The unique number issued by the payer to the owner of the insurance policy. |
Referral # | Display Only (pulled from Claim) |
| The number issued by the primary or referring physician for a specific treatment or treatment series. If a referral number has been entered for the payer on the insurance window, click the applicable referral number from the list. |
Pre-Auth # | Display Only (pulled from Claim) |
| The authorization number issued by the payer for authorization of the treatment or surgery. If you have the pre-authorization number, you can enter it in this column for the payer. |
Claim ID | Display Only (pulled from Claim) | Yes | The identification number issued to the claim when it was generated. |
Contact Phone | Display Only (pulled from Claim) | No | The 10-digit telephone number of the contact person for the plan. |
General Sub-tab |
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| The information displayed in this sub-tab is for the selected line item at the top of the page. If multiple lines are selected, the sub-tab is blank. |
Aging Balances | Display Only (pulled from AR) | Yes | The area has column headings that represent the aging intervals on the account. The past due amounts appear in the appropriate column based on the age of the uncollected past due balance. For example, suppose an account has multiple service fee line items, two of which are past due. One past due amount is 92 days past due and the other is 25 days past due. The amount that is 92 days will be listed under the 91-120 column. The amount that is 25 days will be listed under the 0-30 column. As the past due amounts age, they are placed in the appropriate column according to the number of days past due. |
Guarantor | Display Only (Pulled from created/updated Accounts/Persons) | Yes | The name of the guarantor. The field is a hyperlink that when clicked opens the Update Person / Person Information tab. |
Address 1 | Display Only (Pulled from created/updated Accounts/Persons) | Yes | The street address of the guarantor. |
Address 2 | Display Only (Pulled from created/updated Accounts/Persons) | No | The address line 2 of the street address for the guarantor. |
City/State | Display Only (Pulled from created/updated Accounts/Persons) | Yes | The city, state, and zip code of the guarantor. |
Day Phone | Display Only (Pulled from created/updated Accounts/Persons) | Yes | The 10-digit telephone number (Day) of the guarantor. |
Evening Phone | Display Only (Pulled from created/updated Accounts/Persons) | Yes | The 10-digit telephone number (Evening) of the guarantor. |
Date of Birth | Display Only (Pulled from created/updated Accounts/Persons) | No | The date of birth of the guarantor of the account. |
Account | Display Only (Pulled from created/updated Accounts/Persons) | Yes | The account number of the guarantor account. The field is a hyperlink that when clicked opens the Account: [ID] page. |
Account Status | Drop Down | No | The values in the drop down list assist in grouping and searching for accounts. |
Returned Mail | Checkbox | No | Sets the flag to indicate mail has been returned on the account and follow-up is needed. |
Last Payment Date | Display Only (Pulled from created/updated Accounts/Active AR) | No | Date of the last patient or guarantor payment received on the account. |
Last Payment Amount | Display Only (Pulled from created/updated Accounts/Active AR) | No | The amount of the last patient or guarantor payment. |
Last Payment Type | Display Only (Pulled from created/updated Accounts/Active AR) | No | Designates the type of payment. Values will be: IPYMT or GPYMT. |
Payment Plan | Display Only (Pulled from created/updated Accounts) | Yes | Indicates if there is currently a payment plan on the account. Values will be Yes (if active for the account) or No (if not active for the account). |
Statement Processing | Drop Down | Yes | The option controls whether statements are generated on the account. By default, the option is set to Send. Options include:
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Next System Statement Date | Read-only System-generated | No | The system will generate a statement for the account on the Next System Statement date. If you wish to generate the next statement on a date prior to or after the Next System Statement date, select or enter a date in the Override field. |
Override | Checkbox / Calendar Date | No | If you wish to generate the next statement on a date prior to or after the Next System Statement date, select the checkbox and enter a date in the Override field. |
Service Line Details Sub-tab |
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| The information displayed in this sub-tab is for the selected line item at the top of the page. If multiple lines are selected, the sub-tab is blank. |
Patient | Display Only (pulled from Claim) | Yes | The name of the patient on the case. |
Date of Birth | Display Only (pulled from Claim) | Yes | The date of birth of the patient. |
Subscriber | Display Only (pulled from Claim) | Yes | The person who owns the insurance coverage. |
Subscriber # | Display Only (pulled from Claim) |