Detail Tabs
This is where you can see all the errors when submitting claims or any denials on the account of the patient.
Accession Errors
The bill has been set with a price.
Price Status
This means the accession is in a Third-Party status (has NOT made it to a patient statement yet).
TPSTMT (Third Party Statement Status)
Used when there is a collections vendor in place. The accessions on the file are adjusted to a zero balance and the balance is TRANSFERRED to a collection agency
GENCOLLECTFMT
What is COB?
Coordination of Benefits
This is where all of the previous agents record what they did and when-- read this to get more information on each call.
Contact Notes
It could mean the patient is due a refund or it could be due to incorrect posting or insurance reprocessing which would need to be reviewed and fixed.
CBAL (Credit Balance)
This usually means the patient was sent a welcome letter, depending on the customer.
TPSTMT-PN (PN stands for Patient Notification)
Used when no collections vendor exists, but the customer still wants the auto write-off. The CAM processes these files. Once the file gets marked processed, the accessions in the file will be adjusted to a zero balance, but the accessions will NOT BE TRANSFERRED to a collection agency.
GENCOLLECTFMT2
What is CAM?
Customer Account Management
This is where all patient info is located, and where you update information like their address, phone number, or change the spelling of their name.
Patient Info
This status happens when we are changing the PRIMARY payor on an accession. The accession will be in: “FnlRptd” for about 2-4 hours, and then it will show TPSTMT.
Final Report
This means that it is now in collections or dunning have been exhausted. *Some clients do not send to collections, please check history log and cheat sheet*
COLLECTIONS4
This is used for an automated call.
RevAdv
What is EDI?
Electronic Data Interchange--Same as Electronic Payer ID number
This is where you update the insurance information on file when verifying it with the caller.
Insurance Info
This is usually an indication that something is being posted to the account. This is usually a payment, or it could be an EOB. To confirm please check the payor summary in the billable procedure. You will not be able to make changes to the account until the posting has closed.
Posting
Means the bill is with the client. It will always show the balance as “zero” and the Insurance tab will appear as “C” Client.
CLNSTMT (Client Status)
This has a "B" in the filename.
Welcome Letter
What is MDX?
Laboratories and device customers
This is where you can find the EOB, a breakdown of pricing, and make payments or adjustments. (Line level adjustments for collections are done here.)
Billable Procedure
These go into a automatic bucket for RS to work on - No escalation email is required for this.
Unpriceable
First statement has been sent.
A second statement has been sent.
Third statement has been sent.
PTSTMT1
PTSTMT2
PTSTMT3
How can we open the file in correspondence History?
use the file that has .pdf either under "statement" or "Ack filename"
What is RPM?
Revenue Performance Management