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.

A collection action can be applied to multiple accounts at once. Select one or more accounts by holding the CTRL key, and then click the applicable action button.

How to Get Here?

From the Home Page:	From the Menus:	*Via Shortcut Keys:*
Click Collections from the Manage list. Click the Insurance tab.	Open the Manage menu and select Collections. Click the Insurance tab.	Press [Alt] + [M] + [L]. Click the Insurance tab.

(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

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.

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:

1 - The payer is the primary insurance
2 - The payer is the secondary insurance
3 - The payer is the tertiary insurance

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.

Contact Phone

Display Only (pulled from Claim)

No

The 10-digit telephone number of the contact person for the plan.

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.

Active - patient is currently eligible
Inactive - patient is not currently eligible
Rejected - the Eligibility Inquiry did return a successful response
[Blank] - Eligibility has not been checked for the line item.

General Sub-tab

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:

Send - Statement processing is set to generate statements during normal conditions and at the regular scheduled cycle.
Hold - Statement processing is suspended until further action taken to resume statement processing.

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

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)

Yes

The identification number of the insurance owner.

Member #

Display Only (pulled from Claim)

Yes

The unique number issued by the payer to identify the patient who participates in a group plan. Member IDs and Subscriber IDs can be the same or a different number based on whether the insurance company issues separate numbers to identify its participants. The member identification number is used by some payers to differentiate between the employee and the participating dependents, for example, 00 might identify the employee and 01 might identify the spouse of the employee.

Group #

Display Only (pulled from Claim)

Yes

The unique number issued by the payer to the owner of the insurance policy.

Case

Display Only (pulled from Claim)

Yes

The identification number of the case.

The field is a hyperlink that when clicked opens the Case: [ID] page.

Claim ID

Display Only (pulled from Claim)

Yes

The identification number issued to the claim when it was generated.

Procedure

Display Only (pulled from Claim)

Yes

The procedure performed on the case. The information is displayed with the values: CPT / ASA.

Diagnosis

Display Only (pulled from Claim)

Yes

The diagnosis codes of the procedure performed on the case.

Date of Service

Display Only (pulled from Claim)

Yes

The date the services were rendered.

Provider

Display Only (pulled from Claim)

Yes

The name of the provider of the service.

TIN

Display Only (pulled from Claim)

Yes

The tax identification number of the provider.

Provider NPI

Display Only (pulled from Claim)

Yes

The NPI number of the provider.

Group NPI

Display Only (pulled from Claim)

Yes

The NPI number for the provider group (facility).

Facility

Display Only (pulled from Claim)

Yes

The facility where the services were rendered.

Procedure Amount

Display Only (pulled from AR)

Yes

This field displays two values for the claim: Amount Billed / Current Balance.

Total Claim Amount

Display Only (pulled from AR)

Yes

This field displays two values for the claim: Amount Billed / Total Whole Claim.

Plan

Display Only (pulled from Claim)

Yes

The name of the plan to which claims are submitted.

Payer ID

Display Only (pulled from Claim)

Yes

The unique payer identification number.

Contact

Display Only (pulled from Claim)

Yes

The contact name for the responsible plan.

Phone

Display Only (pulled from Claim)

Yes

The phone number for the responsible plan.

Fax

Display Only (pulled from Claim)

No

The fax number for the responsible plan.

Website

Display Only (pulled from Claim)

No

The website for the responsible plan.

Plan Address 1

Display Only (pulled from Claim)

Yes

The address (line 1) for the responsible plan.

Address 2

Display Only (pulled from Claim)

No

The address (line 2) for the responsible plan.

City, State, Zip

Display Only (pulled from Claim)

Yes

The city, state, and zip code for the responsible plan.

Appeal Address 1

Display Only (pulled from Claim)

Yes

The address (line 1) for the responsible plan's appeals office/location.

Address 2

Display Only (pulled from Claim)

No

The address (line 2) for the responsible plan's appeals office/location.

City, State, Zip

Display Only (pulled from Claim)

Yes

The city, state, and zip code for the responsible plan's appeals office/location.

Additional Info

Display Only (pulled from Claim)

No

Additional plan information of the responsible plan.

Account Notes Sub-tab

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.

Created

Read-only

(system-generated)

Yes

The date and time the note was saved.

Case

Read-only

No

This note was entered on the Notes tab of the indicated case. Click the hyperlink to open the applicable Case: [ID] page.

Note

Display Only

(pulled from created Notes)

Yes

The text of the note.

Type

Display Only

(pulled from created Notes)

Yes

The Note Type assigned during creation of the note. Options include:

Account
Case
Collection
Payment
Refund

Created By

Read-only

Yes

The person who created the note.

Collection Actions Sub-tab

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.

Action Date

Read-only

(system generated when the action is created)

Yes

The date and time the action was initiated. The action date is displayed in the following format: mm/dd/yyyy.

Note

Display Only

(pulled from created Action/Action Series)

No

The text of the note added to the action.

Initiated By

Read-only

(system generated when the action is created)

Yes

The name of the person who initiated the action. For a system-generated action, this value is System. For an action entered by a person, the value is displayed in the following format: last name suffix, first name, and middle name, for example, Smith Jr., John Adam.

Action

Display Only

(pulled from created Action/Action Series)

No

The description of the action. This description can be system-generated or entered by a user.

Samples include:

Action Type

Description

System

Guarantor balance transferred to internal collections.

Guarantor balance returned from internal collections.

User

Called Mr. Smith to discuss a payment plan.

Called Mrs. Jane Jones and left voicemail message.

Next Action

Display Only

(pulled from created Action/Action Series)

No

The pre-defined action the collector will perform next in the series of actions. The Action Type is defined in the practice configuration and determines the series of events that will occur in the collection effort.

Next Action Date

Display Only

(pulled from created Action/Action Series)

No

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.

Letter

Display Only

(pulled from created Action/Action Series)

No

The identification number assigned to the collection letter when it is generated.

Only populated if the action has a collection letter attached to it.

Collection letters can be generated and printed on demand or printed later in a collection letter batch from the Collection Letters page.

Letter Layout

Display Only

(pulled from the action types created for the practice)

No

The collection letter that is linked to the action. This layout determines the content of the collection letter.

Only populated if the action has a collection letter attached to it.

Printed At

Read-only

(system generated when the letter is generated)

No

The time and date that the letter was initially printed.

Only populated if the action has a collection letter attached to it.

Button Descriptions

Button	Shortcut Keys	Description	Step-By-Step Guides
Search	[Alt] + [S]	To search and locate guarantor accounts in collection.	Click Search. The Insurance Search Criteria window opens. Enter search criteria. Click OK.
Account	[Alt] + [A]	To review and manage a guarantor account.	Select the account to review. Click Account. The Act: [ID] page opens.
Reassign	[Alt] + [R]	To reassign collection tasks from one collector to another for either guarantor or insurance collections.	Reassigning Collection Tasks
Print	[Alt] + [P]	To generate the Guarantor Collection Tasks report, which contains the contents of the collections tasks that are currently listed on the Guarantor tab, excluding collection actions.	Click Print. The report is displayed in the default preview window.
Message	[Alt] + [M]	To create a message or task for another Connect user related to the insurance collections on the practice.	Click Message. The Message window opens. Open the To drop down list and select the message recipient(s). Enter a Subject for the message. (Optional) If the message pertains to assigning a task, select the Task checkbox. (Optional) If the Task option is selected, the Due Date field is enabled and a date must be entered. The Insurance Collections and Account information auto-populates the Message field upon creation of the message. It can be edited if needed. Enter the Message text. Click Save.
View Attach	[Alt] + [V]	To open the Image Viewer window for the line item's attachments.	Select the service line item with an attachment. Click View Attach. The Image Viewer window opens with the attachment displayed. If you select a service line item without an attachment, a message displays: Click Yes to open the Image Viewer window and create the image set.
Rebill	Not applicable	To rebill the service line item.	Perform the system rebill: Rebelling Claims with Fee Changes Rebilling Claims without Fee Changes
Review Eligibility	Not applicable	To check the Eligibility check history for a single line item.	Select the line item to review. Click Review Eligibility. The Charge Batch / Eligibility tab opens to display the Eligibility Summary and history for the selected line item.
Check Eligibility	Not applicable	To submit an Eligibility check for one or more line items.	Select the line(s) item to submit. Click Check Eligibility. The Check Eligibility window opens. Select the case(s) for submission of an Eligibility request. Click Submit. The Check Eligibility window closes. You can also click the Submit and Review Response button to submit. Upon clicking, the Check Eligibility window closes and the cases are submitted. The Charge Batches / Eligibility tab automatically opens with the associated Charge Batch ID selected and the response displayed in the sub-tabs.
Create	[Alt] + [T]	To create a collection action for guarantor and insurance collection tasks.	Creating Collection Actions
Print Letter	[Alt] + [L]	To print a collection letter from the Collection Actions section.	Printing Collection Letters on Demand
General Sub-tab
Demand Statement	Not applicable	To generate a statement before the regularly scheduled statement cycle.	Generating Demand Statement
Account Notes Sub-tab
Search	[Alt] + [E]	To find a note.	Click Search. The Search Criteria window opens. Enter search criteria. Click OK.
Create	[Alt] + [T]	To add a note to the account.	Creating Account Notes