4th attempt. Collection efforts exhausted
Write Off
Collected Date and Amount Collected have value. Provider Payment Details available
PAID
BILL INELIGBLE FOR EXPORT
MIA
Claim: WC868-D08621
Patient Name: Juvencio Ibarra Alcaraz
TIN: 470975781
Provider name: Active Performance Physical Therapy
DOS: 4/26/2021
Paid
Payment details email
Provider request EOB for DOS 6/14/2018. Who provides the EOB?
ACCOUNTING
DOS has been rebilled to the carrier. Please allow 45-60 days
Within TAT
Age of AR is <60 days. No collected date or amt collected
WITHIN TAT
List the 4 criteria for Fully Outstanding
Claim: 4035365
Patient Name: Deborah Lewis
TIN: 920189705
Provider name: Westlake Sports Therapy Inc
DOS: 3/30/2021
WITHIN TAT
STILL PROCESSING EMAIL
List the 4 Leased Networks
Multiplan
Stratose
Optum
Magnacare
Provider paid correctly per day rate/fee schedule
PAID
Collected Date is 1/1/2021, No amount collected, Payable is $0 in billing box
WRITE OFF
Reject Bill Acknowledgement
INVALID RTP
Claim: 7151804
Patient Name: Stephanie Smith
TIN: 593747797
Provider name: Advanced Physical Therapy of Lake Co
DOS: 2/22/2021
FOAR
CREATING A PIL
Received an email from Gallagher Bassett. Who does this email get forwarded to?
LEIGH MILLIGAN
CIARA WARD
Outreach has been made to the carrier/adj
Actively being worked
30 calendar days
Age of AR >60 days. All lines priced. No active collection note
FULLY OUTSTANDING/ FOAR
DCN is less than a year
MIA
Claim: 005683003343WC01
Patient Name: Paul Garnet
TIN: 208666329
Provider name: Atwood, Amanda
DOS: 8/31/2020
MIA
CREATING A PIL
TRUE OR FALSE?
For Wrap Rate providers, if one cpt code bills at $0, this is considered MIA
TRUE
Claim denied by adjuster as not a work related injury
DENIED
Payment paid to incorrect provider
REFUND REQUEST
Claim denied for a valid reason but provider is challenging it
Suggest the appeal process
Claim: 301938015090001
Patient Name: Jose Gomez
TIN: 592355972
Provider name: Physicians Health Center
DOS: 11/4/2019
VALID RTP
EMPLOYER CARVE OUT TEMPLATE
TRUE OR FALSE
MEDRISK CAN PROCESS PARTIAL PAY LOGS FOR MULTIPLAN PROVIDERS
FALSE