Overview
Purpose
This report is used as a tool to review or work outstanding balances, based on date of service criteria. It identifies unpaid claims by payers so collectors can follow up with payers. The report shows the details of the claims submitted to a specific payer for a particular plan by patient and subscriber. This report includes provider, NPI, facility, procedure code, date of service, quantity, billed amount, current balance, payer rank, claim ID, claim date; member number, group number, and days outstanding.
Category
Management
Type
Detail
Mode
Date of Service
Output Options
View/Print, CSV, Excel, or PDF
Sample Report
(Click the image to enlarge)
Field Definitions
Field | Calculation Formula | Description |
|---|---|---|
Provider | The name of the provider (last name, first name) who performed the procedure on the case. | |
NPI | The national provider identification number issued to the provider. | |
Facility | The name of the facility where the patient was treated. | |
CPT | The procedure code of the procedure performed. | |
DOS | The date the procedure was performed. | |
Qty | The quantity of the procedure. | |
Billed Amt | The amount billed to the payer. | |
Balance | The current balance of the claim. | |
Rank | The insurance ranking of the payer (1=primary, 2=secondary and 3=tertiary). | |
Claim | The identification number issued to the claim when it was generated. | |
Last Claim | The date that the claim was generated. | |
Member # | The identification number of the member. | |
Group # | The identification number of the group. | |
Days O/S | The number of days outstanding since the claim was generated. |
Available Report Filters
Option | Type | Required | Description |
|---|---|---|---|
Date of Service Begin | Drop Down | Yes | Filters by the beginning date of the date of service for the claims that you want to include in the report. By default, this filter is set to January 01 of the current year, for example,12 -01-01. |
Date of Service End | Drop Down | Yes | Filters by the ending date of the date of service for the claims that you want to include in the report. By default, this filter is set to the current date. |
Facilities | List Selection | Yes | Filters by all facilities or by one or more facilities. By default, this filter is set to All Facilities. |
Financial Classes | List Selection | Yes | Filters by one or more of the following options: Commercial, Medicare, Medicaid, Workers Comp, or Self-Pay. |
Payers | List Selection | Yes | Filters by all payers or by one or more payers. By default, this filter is set to All Payers. |
Plans | List Selection | Yes | Filters by all plans or by one or more plans. By default, this filter is set to All Plans. |
Practices | List Selection | Yes | Filters by all practices or by one or more practices. By default, this filter is set to All Practices. |
Procedure Categories | List Selection | Yes | Filters by all procedure categories or by one or more procedure categories. By default, this filter is set to All Categories. |
Providers | List Selection | Yes | Filters by all providers or by one or more providers. By default, this filter is set to All Providers. |