Concuity 101
Contracts and Reimbursments
Workflows
Navigation
Tabs
100

What is the default view when first log into Concuity?

What is the Home screen

100

What term describes the contractual discount amount that adjusts the expected reimburstment amount from the payer?

What is Adjustment

100

Who assignes your workqueues work list?

Your manager/leadership

100

Where do you access Concuity from?

From the PSC Apps page

100

Where do you find the EOB/ERA?

The 835 Tab

200

This tells you where the account is in the payment compliance flow.

What is the Status Code

200

What term refers to the amount Concuity calculates based on total charges and the iPlan formulas in the payer contract?

Expected Reimbursement

200

How is the Reason Code assigned?

By the user

200

Once you are done working an account, what do you do next?

Click Get Next

200

Patient Demographics can be found in what tab?

The Patient Tab

300

Which patients can be linked in Concuity?

Mom and baby

300

Concuity calculates what we are owed based on the contract between whom?

Hospital & Insurance company

300

Are all discrepancies worked regardless of amounts?

No, we work accounts within threshold

300

Where do you access work for the day?

You click on the Work Queues tab

300

Which tab houses all the details of the calculation performed by Concuity?

The Calcs Tab

400

What functions do iplans control?

Financial class, contractual adjustments, and rate scheduled

400

How is the expected reimbursement calculated in Concuity?

The provider contracts are loaded into the system and creates formulas per the iplan

400

What do the Reason codes control?

The activity type options

400

Where can users view all the notes on an account?

The Activity Summary button under the Activities Tab

400

Which tab houses the charge and coding information?

The Details Tab

500

A valid discrepancy or denial means what?

We expect money to exchange hands

500

Is the amount due in Concuity the same as the A/R balance on the account?

No, Concuity tracks the discrepancy between what we were paid and what we expected. A/R balance is the actual amount due.

500

How do you generate a reconsideration letter to send to the payer?

Through the Correspondence button under the Activities Tab

500

What do you do if you cannot work the next account that comes up?

Click Get Next and select a Bypass reason

500

Where can you find the authorization, if there is one?

The Payer Tab