Create a variety of custom defined, real-time, interactive worklists for your collections team to work A/R, denials and timely filing. Eliminate report printing and work on a dynamic worklist on the spot.
Configure the worklist according to your preferences and needs. Worklist rules are flexible, allowing you to recreate your current collection reports as worklists. Unlike working from a report, the worklist will pull real-time A/R, claim and denial information.
Concerned with meeting deadlines? Create worklists to meet that deadline and resubmit claims.
Research the A/R from one application. You have visibility to all the information you need to take action on a patient’s account and the EOB. Gain access to the patient’s open and historic A/R, full history of a line's A/R transactions, worked history and claim tracking information. All of the actions, navigations and line details are available at the account level.
Every action is tracked and logged in the worklist so that you know who has done what and when on the worklist. Status codes are used to track your actions. Anytime you’ve taken an action in the worklist, it will fall off your list. Increased visibility of your data and efficiency within the worklists make life easier.
View A/R details by looking at “Review Line Detail.” View the history of a line, and the original invoice line. Find out who worked on the line, as well as adjustments made to the line. Basic history of what happened to the line is at your fingertips.
Once you’re in the worklist, you can resubmit claims and update line states. You have the option to generate and send claim appeals with attachments, using payer specific appeal forms. Retain the ability to print hardcopy claims on demand and transfer and write-off A/R. Your notes and tasks perfectly integrate with these tools.
The billing of goods and services is a time-consuming task. Processing Accounts Receivable often consists of dotting your i’s and crossing your t’s repetitively. Paperwork usually overwhelms the process as some struggle to efficiently manage the workload...
Sample worklists could include claims at risk of missing their timely filing deadline; A/R over $500 and 90 days past due that has not been worked in 30 days; A/R Aging; Date of Service (DOS); Claim submit date; Invoice date; Days past due; Denial Amount; Claim Status; Timely appeal filing; Status and Denial Codes; Diagnosis. Worklists are user-defined, according to your personal preferences.
Filter and work A/R by collection payer set. Group insurance companies through the collections payer set, under Billings Rules Setup. Divide the collections agents by payer set. Conduct an Alpha split by working only specific names between letters “A-J”. Additional filters to work A/R include the branch, HCPCS, patient state, claim status, status code, denial code, claim form and the diagnosis. Upfront filtering is done to avoid any hassles later.
Define dollar amount approval limits that require supervisor approval before they can be posted, and assign the users who are responsible for the approval. Review, approve and deny the adjustments that require approval from a worklist application. Communicate a denial to the collection agent with a task to correct and resubmit or delete the adjustment. You are able to monitor applications that increase visibility to adjustments pending approval by total amount and age, and by the user who did the adjustment by batch and by assignment.
Appeal Form Setup – You can create your own custom appeal forms according to your needs. Download them from the payers website. Keywords are utilized to easily see who is submitting the patient information.
Cash Batch Setup – Create A/R batches. Every A/R batch needs a cash account. You can define that default cash account so that you don’t have to put it in every time.
Worklist Setup – You can design and create your own custom worklist. Display A/R on your worklist when A/R is more than $500. You have the option to look at an age by due date, by date of service, by invoice date, or by claim submission date. You can also view it if there is a denial.
Timely Filing – You can create yourself a specific time period and worklist to complete all actions before that time expires.
Easily navigate to patient information, claim tracking, CMNs/Supporting documents. Click on medical documentation and the patient’s documents will be listed under supporting documents.
When doing an adjustment that is over the dollar threshold that requires approval, the user can enter an adjustment explanation.
Create A/R notes for every action, whether you print redetermination, transfer/write-off A/R, mark a line or resubmit a claim. Notes are in the form of child windows. View A/R notes at the line level, or see all A/R notes for the account. The notes title populates with the action taken or the task title defined for that status code. If a note is created when generating a claim appeal, the image of the appeal is viewable from the note.
If an action taken on a line uses a status code that requires a follow-up, a task is created instead of the note. The collector then can assign the task to themselves or someone else.