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Overview

The Collections Admin pages are comprised of seven tabs:

The Insurance Collections tab includes rules to automate internal collection processes on past due guarantor accounts in insurance responsibility and defines actions for executing internal collection efforts for all practices at the enterprise level.

A practice from the Insurance Collections tab can be selected and updated to access it's unique Insurance Collections: [Practice Name] page. From here, the enterprise-level rules and actions can be customized for the selected practice.

How to Get Here?

To open the Insurance Collections tab for new practice:

From the Home Page:
From the Menus:
  1. Click Collections Admin from the Admin list.
  2. Click the Insurance Collections tab.
  1. Open the Admin menu and select Collections Admin.
  2. Click the Insurance Collections tab.


To open the 
Insurance Collections: [Practice Name] page for a specific practice:

From the Home Page:
From the Menus:
Via Shortcut Keys: 
  1. Click Collections Admin from the Admin list.
  2. Click the Insurance Collections tab.
  3. Select the practice from the Practice Configuration table.
  4. Click Update.*

*Alternate Navigation: Double-click the practice from the list.

  1. Open the Admin menu and select Collections Admin.

  2. Click the Insurance Collections tab.
  3. Select the practice from the Practice Configuration list.
  4. Click Update.*

*Alternate Navigation: Double-click the practice from the list.

  1. From the Collections Admin / Insurance Collections tab, select the practice to be modified.
  2. Press [Alt] + [U].

 

(Click an image below to enlarge.)

Insurance Collections Tab


Insurance Collections: [Practice Name] Page

 



Field Definitions

Field

Type

Required

Description

Insurance Collections Tab

General Information Section


Enterprise Rules

Free Text (Numeric)

Yes

These options are used for configuring insurance collections. To configure insurance collections activation, enter the criteria for tagging a guarantor account in guarantor responsibility as internal collections in Connect.

The following criteria is required to activate insurance collections:

Generate an insurance task when the balance is greater than $_____ , AND

The value used to evaluate the service line balance, for example, $5.00. Enter the dollar amount to use for part one of the criteria. Field is used to define service line balance qualification minimum.
The balance is more than ___ days past due The value used to evaluate whether the service line is past due, for example, 45 days. Enter the number of days to use to determine delinquency. A value between 0 and 999 can be entered. Field is used to define account age qualification minimum.

When a service line meets both of these conditions, the account will be tagged as internal collections and insurance collection activities will begin in Connect.

Force Collection Action Notes to show as Account NotesCheckboxNoIf checked, all Collection Action Notes (across the enterprise) are automatically also added to the Account/Notes tab and tagged as Note Type: Collections.
Practice Configuration Table


Practice

Display Only

(Pulled from created/updated Practices)

YesA listing of all practices for the account with overview collections setup information (enabled, level).
Collections Enabled

Display Only

(Pulled from created/updated Insurance Collections: [Practice Name] Page)

Yes

Collections designation of the practice.

  • If collections is enabled for the practice (via the Insurance Collections: [Practice Name] Page), the "Yes" value is displayed in the field.
  • If collections is disabled for the practice, the "No" value is displayed in the field.
Assignment Level

Display Only

(Pulled from created/updated Insurance Collections: [Practice Name] Page)

Yes

Collections assignment level designation of the practice.

  • If collections task assignment is tied to the enterprise level rules, the "Enterprise" value is displayed in the field.
  • If collections task assignment is customized to follow practice specific rules (defined via the Insurance Collections: [Practice Name] Page), the "Practice" value is displayed in the field.
Insurance Collections: [Practice Name] Page
Enable Insurance Collections

Checkbox

No 

Locks and unlocks the practice's participation in Insurance Collections. If unchecked, all fields on the page are disabled.

Task Generation Section


Override Enterprise Generation RulesCheckboxNo

Designates if the practice is following the enterprise-level Insurance Collections rules or the rules defined at the practice-level. If checked, the Task Generation fields are enabled for definition.

If the Override Enterprise Generation Rules field is unchecked, the enterprise-level information is displayed in read-only format in the fields.

Enterprise RulesFree Text (Numeric)Yes

These options are used for configuring the selection parameters for service line assignments at the practice level. To configure insurance collections activation, enter the criteria for tagging a service line to insurer responsibility in Connect.

The following criteria is required to activate insurance collections:

Generate a task when the balance is greater than $_____ , AND

The value used to evaluate the service line balance, for example, $5.00. Enter the dollar amount to use for part one of the criteria. Field is used to define service line balance qualification minimum.

The balance is more than ___ days past due The value used to evaluate whether the service line is past due, for example, 45 days. Enter the number of days to use to determine delinquency. A value between 0 and 999 can be entered. Field is used to define account age qualification minimum.

When a service line meets both of these conditions, the account will be tagged as internal collections and insurance collection activities will begin in Connect.

Force Collection Action Notes to show as Account NotesCheckboxNoIf checked, all Collection Action Notes on the account are automatically also added to the Account/Notes tab and tagged as Note Type: Collections.
Task Assignment Section 

Assigns internal collectors to the guarantor accounts tagged as internal collections. These options are only available when the Enable Guarantor Collections option is selected.
Assignment Type Drop DownYes

Determines how tasks are assigned to internal collectors. The criteria for assigning tasks to internal collectors by the first letter in the payer name (A through Z), a dollar amount range, specific payer, or specific payer and plan.

Options include:

  • For Payer Name Range, you might enter A through D for one collector and E through H for another collector.
  • For Balance Range, you might enter $500 through $2,500 for one collector and $2,501 through $10,000 for another collector.
  • For Payer / Plan, you might select Aetna for the payer and PPO for the plan. 

If you change the Assignment Type, any values in the Task Assignment table that have been configured will be deleted.

Default Collector Drop DownYes 

The internal collector to which accounts are assigned based on the assignment rules. Any account/service not captured in the assignment rules is assigned to the default collector.

Default ActionDrop DownYesAny tasks created that fall outside the assignment table rules or fall within a rule without a defined default action will be assigned the designated Default Action.
Assignment Rules Table 

Defines the task assignment rules. The fields displayed will vary depending on the Assignment Type selected.

From / ToDrop DownNo

For Payer Name Range, select the first letter of the payer name in the From and To columns to create the range of letters for the payer names that you want to assign to the internal collector.

For Balance Range, enter the dollar amount range for the account balance you want to assign to the internal collector.

Payer / PlanDrop DownNoFor Payer/Plan, select the payer or select the payer and plan you want to assign to the internal collector. You must select a payer and a collector. Plan is optional and only needs to be selected if you are assigning accounts to a collector by payer and plan.
Name - From / Name - ToDrop DownNoFor Payer/Plan, select the first letter of the patient name in the Name - From and Name - To columns to create the range of letters for the patient names that you want to assign to the internal collector.
Collector / GroupDrop DownNoThe assigned collector, or group, for the range.
Override Days

Free Text

(Numeric)

NoValue entered to override the number of days past due for a particular payer or plan. Instead of using the number of days specified in the enterprise generation rules, the insurance collection rules use the override days specified for the plan. This option is only available when the Assignment Type is set to Payer Name Range or Payer/Plan.
Action / Series

Display Only

(Pulled from created/updated Task Assignment)

No The assigned action, or action series, for the range.

Button Descriptions

Field

Shortcut Keys

Description

Step-by-Step Guides

Insurance Collections Tab


Update[Alt] + [U]To modify the insurance collections rules and task assignment for the selected practice.
  1. Select the practice to be modified.
  2. Click Update. The Insurance Collections: [Practice Name] Page opens.
  3. Make modifications as needed.
  4. Click Save or Apply to save the changes.
Insurance Collections: [Practice Name] Page


Ad[Alt] + [D]

Defines a collection task assignment rule.

  1. Click Add. The Add Task Assignment window opens.

    Notes:

    The Practice and Assignment Type fields default based on the practice and defined Assignment Type for the practice.

    The available fields on the Add Task Assignment window will vary depending on the Assignment Type selected.

  2. For Payer Name Range:
    1. Enter the From/To values (first letter of last name) relevant to the rule being defined.
    2. (Optional) Enter the Override Days.
    3. Open the Collector / Group drop down list and select the assignee (individual or group) for the rule being defined.
    4. (Optional) Open the Default Action/Series drop down list and select the action or action series to assign based on the rule.

  3. For Balance Range:
    1. Enter the From/To values (balance amount) relevant to the rule being defined.
    2. Open the Collector / Group drop down list and select the assignee (individual or group) for the rule being defined.
    3. (Optional) Open the Default Action/Series drop down list and select the action or action series to assign based on the rule.

  4. For Payer/Plan:
    1. Open the Payer drop down list and select the payer to be assigned to the collector.
    2. (Optional) Open the Plan drop down list and select the plan to be assigned to the collector.
    3. Enter the Name - From (Patient) and Name - To (Patient) values.
    4. (Optional) Enter the Override Days.
    5. Open the Collector / Group drop down list and select the assignee (individual or group) for the rule being defined.
    6. (Optional) Open the Default Action/Series drop down list and select the action or action series to assign based on the rule.

      Note: The Default Action/Series selection is not required if a common, or default, action is not valid or useful for the assignment rule.

  5. Click Save or Save & Add Next to save the new collection action and create an additional one.
Update[Alt] + [U]Updates a collection task assignment rule.
  1. Select the rule to be updated.
  2. Click Update. The Update Task Assignment window opens.
  3. Enter the assignment rule modifications.
  4. Click Save or Save & Add Next.

Remove

[Alt] + [R]

Removes an assignment rule.
  1. Select the assignment rule to be deleted.
  2. Click Remove. The rule is removed from the list.


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