Collection Manager is an interface provided by Practicesuite to enable easy and consistent follow up of accounts receivable. It helps the Account Receivable to follow up a claim at regular intervals until the claim close. Thus, the Provider Collection increases while reducing the provider expenditure on claim processing.
Note: The collection manager will project only outstanding claims.
Search Criteria Section
Collection Manager has various search fields which help to filter the claims based on the requirements.
|Denials||This radio button is used to filter claims which have been denied.|
|Claims over payer response Limit Threshold||This filters claims for which no response has yet been received even after the threshold is reached. The default claim response limit can be set up at Advanced Setup-> Billing Options.|
|All||This is used to display all claims under both ‘Denials’ and ‘Claims over payer response Limit Threshold’.|
|All Open Lines||This radio button displays all claims that have a balance (remaining) amount. Denied and no response claims are separately listed under their respective denial and no response categories. The remaining open claims will be shown in the respective payer categories.|
|Denial Category||Helps filter claims that fall under a specific denial category. This is a multi-selection field where multiple denial categories can be selected from the drop-down.|
|Coll. Status||Helps to filter claims based on the collection statuses-NEW, PENDING, RESOLVED, etc. This is also a multi-selection field.|
|Coll. Sub Status||Helps to filter claims based on the collection sub statuses (Claim Resubmitted, Paid EOB requested, Paid ERA in Transit, etc.) This is again a multi-select field.|
|Legal Entity||Select a Legal Entity from the drop-down to display claims in that LE.|
|Provider||Select a Rendering provider to filter based on Rendering Provider|
|Patient||Type in the first three characters of the patient name or MR # and select an appropriate patient to filter for a particular patient.|
|CPT||To filter claims according to procedure code. Multi-select field|
|ICD||To filter claims with the given ICD codes. Multi-select field.|
|Modifier||Provide modifiers to filter the claims. Multi-select field|
|Show Claims in Next Action Queue||This, if checked, displays claims already pushed to the work queue.|
|Aged between: DOS/LCD/LFD||Claims can be filtered according to days from DOS, LCD(Last Claim Date), and Last Follow up Date.|
|Date between: DOS/ Claim Date||Filter claims according to whether their DOS and/or claim date fall in the given date range.|
|A/R Method||Web/Calling/VOB. Select one from the drop-down|
|Amt >||To filter claims with amount more than the specified value|
|Collector||To filter claims by the user who works on the claims in the collection manager|
|Assigned To||To filter claims by the user to whom a task has been assigned in the collection manager.|
Categorized Search Result
According to the search criteria provided, the results are displayed as in Image 3.
To view the claims in any category, click anywhere on the category line, and the corresponding claims are listed as shown in Image 4.
The flexible drag feature provides users to adjust the grid size of the bottom claim listing section.
Multiple claims can be selected in the selected category (through the multi-select option) for adding a collection note and to record the collection activity for all the selected claims; see Image 4.
Color Codes in claims listing
Age since DOS and Age since Last INS remittance received fields are color-coded to indicate the priority of the claim, as shown in Image 5.
Table 2 explains the different color codes.
|Color (DOS & Last INS remittance received)||Indication|
|Red||More than 45 days|
Click anywhere on the claim line to open the encounter line for follow up. Denials workshop screen will pop up with details of the invoked encounter.
The different sections of the denials workshop are numbered (as highlighted in Image 5) and explained below.
1. Patient and Claim details: Patient demographics and claim details can be found in this section.
2. Encounter lines and its details: Encounter line details can be found in this section.
3. Links: Help in navigating to other pages such as Patient demographics, case, insurance, Charge Master, ledger, eligibility, document Management.
4. Claim History and previous notes: This section has four tabs- Line activities, Denial History, Follow-up History, and Claim status history.
5. Follow up notes and status section: This section lets you update notes and tag follow up status and sub status for future follow up. The claim status and sub status can be updated here.