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The Claims With Missing Information (By Insurance) report within the Report Writer application provides a listing by insurance company of all claims at the unchecked status. The Claims With Missing Information can be run to allow billers to review claims at the unchecked status. The report includes the age of the claims at the unchecked status. The aging selections are Current, Over 30, Over 60 and Over 90 days.

 

If a claim appears on this report, then it should be for one of two reasons. First, it may be an APC claim, which will autogen to the Unchecked status if the Auto Gen to Ready-to-Bill field on page 4 of the Insurance Company table is set to N and will contain the message “APC Claim” in the Comment field. Second, if the claim is not an APC claim, then it was most likely manually set back from the Ready To Bill status and the reason should be placed in the comment field. The APC claims will move to the Ready To Bill status once a M/R Verified Date has been placed on the claim and the APC Claims to Ready to Bill report has been run. The non-APC will not automatically move from the Unchecked status to the Ready To Bill status and will need to be manually reset to Ready To Bill when ready.

 

NOTE: The advancement of APC claims depend on how the Insurance Company table is set.

 

 

Claims With Missing Information (By Insurance)

 

 

 

Claims With Missing Information (By Alpha Summary)

 

 

 

Claims With Missing Information (By Service Code Summary)

 

 

 

Claims With Missing Information (By Insurance Company Summary)

 

 

 

Claims With Missing Information (By Grand Total Summary)

 

 

 

Listed below is an explanation of each column.

 

•Claim Type: Pulls from the Insurance Claims by Patient screen.

 

•Account Number: Pulls from the Registration and ADT screen. If this account is a repeat admission within 72 hours, the flag “72H” will pull after the Account Number.

 

•Ins (Insurance): Pulls from the Insurance Claims by Patient screen.

 

•Patient Name: Pulls from the Full Name field in the Patient tab on the Registration and ADT screen.

 

•Discharge Date: Pulls from the Stay tab on the Registration and ADT screen.

 

•Amount to be Billed: Pulls from the detail charges screen.

 

•Cur (Current): An “X” pulls to this column if the Discharge Date is less than 30 days old.

 

•30: An “X” pulls to this column if the Discharge Date is over 30 but less than 60 days old.

 

•60: An “X” pulls to this column if the Discharge Date is over 60 but less than 90 days old.

 

•90: An “X” pulls to this column if the Discharge Date is over 90 days old.

 

•Physician: Pulls from the Patient tab on the Registration and ADT screen.

 

•Reason for Not Billing: Pulls from the Comment field of the Insurance Claims Status screen.

 

•M/R Comp (Medical Record Complete): A Y indicates Medical Records coding is complete and the Finish Date has been added to the grouper screen. A N indicates that coding is not complete.

 

•Serv Cd (Service Code): Pulls from the Patient tab on the Registration and ADT screen.

 

•Coder: Pulls the coders initials from the Finish Date field on the Grouper screen.