Overview


This report is used to review insurance plan configurations and demographic information.

Category

System

Type

Detail

Mode

Not applicable

Output Options

CSV or Excel



From Portal:
From Back Office:
  1. From the Reports tab, locate the Plan Detail report.
  2. Click Edit for the report.
  3. Enter/select filter criteria on the Criteria page.
  4. Click Run Report.
  1. Open the Manage menu and select Reports.
  2. From the Reports page > Modern tab, select the Plan Detail report from the list of reports.
  3. Click Run (or press [Alt] + [R]).
  4. Enter/select the filter criteria from the Parameters window.
  5. Click Run (or press [Alt] + [R]).



 

Sample Reports

(Click an image to enlarge)

Portal


Back Office



Field Definitions

Field

Description

PracticeThe name of the practice.
Payer NameThe name of the parent payer to the plan.
Plan Name  The name of the plan.
Address Line 1 The address line 1 of the street address of the plan.
Address Line 2 The address line 2 of the street address of the plan.
City The city of the plan.
State The state of the plan.
Zip CodeThe postal ZIP code of the plan.
Contact Name The name of the primary contact for the plan.
Contact Phone The 10-digit telephone number of the primary contact for the plan.
Contact Fax The 10-digit facsimile number for the plan.
Contact Email The electronic email address of the primary contact for the plan.
Website The URL to the website for the plan.
Financial Class Indicates the grouping the plan on the case is in. Financial class is used for reporting purposes. For example, you can set up either a managed care financial class or a more detailed break down delineating PPO and HMO classifications.
ClearinghouseThe name of the associated clearinghouse that distributes claims to the correct insurance payer.
Payer ID The unique identification number of the plan for the clearinghouse.
Claim Type The abbreviation that identifies the type of claims that will be generated for the plan, for example, Automobile Medical (AM), Commercial Insurance Company (CI), Disability and Health Maintenance Organization (HM).
Billing Provider TypeThe provider type who is the billing provider when claims are generated.
Team Billing The type that identifies whether claims include charges for a physician and a CRNA when involved on the same case that results in team billing. Claims can include charges for the physician only or the physician and CRNA, or the physician or CRNA.
Concurrency Scheme NameThe name of the concurrency scheme selected for the plan.
Extreme AgeIndicates whether the plan allows the extreme age modifier.
EmergencyIndicates whether the plan allows the emergency condition modifier. 
Primary Claim Type The primary claim format for the plan, e.g., Electronic, Drop to Paper, Self-Print.
Secondary Claim Type The non-primary claim format for the plan, e.g., Electronic, Drop to Paper, Self-Print.
Paper Claim Form The claim format used for paper submission of claims on the plan.
Effective Date The effective date of the plan.
Expiration Date The expiration date of the plan.
Network StatusProvides quick identification if the plan is in or out-of-network.
Contract Effective DateThe date the provider begins accepting the plan.
Inactive A "Yes/No" flag to indicate if the plan is currently active.
Billed Fee ScheduleThe name of billing fee schedule on the plan.
Expected Fee ScheduleThe name of the expected fee schedule on the plan.


Available Report Filters

Option

Type

Required 

Description

PracticesList SelectionNo 

Filters by one or more practices. By default, this filter is set to All.

Only active practices are returned in the search results.

PayersList SelectionNo Filters by one or more payers. By default, this filter is set to All.
Plans List SelectionNo

Filters by one or more plans. By default, this filter is set to All.

Report FolderDrop DownYesDesignates where to place or save the output from the executed report.




Search this documentation