Performing Insurance Functions

Creating Claim Reports

Claim reports enable you to monitor the status and amount of claims in the software. You can print a list of all patient claims of a particular type (Actual, One-time, Continuation of Treatment, or Pre-authorization) that you have entered, regardless of whether they have been printed. You can print a separate report for each claim type, for any date or range of dates. In addition, if your practice has multiple doctors and locations, choosing the desired options can narrow the listing of claims even further.

To set up claim reports:

1. Click the Insurance Functions button from the main menu. The Insurance Functions menu is displayed. Select Claim Reports.

OR

Select Functions > Insurance Functions > Claim Reports from the menu bar. The Insurance Claim Reports window is displayed.

This window has several sections with different options that allow you to define what is included on the printed report. Note that some options are inactive (you cannot select them). For example, in a practice with one location/one doctor, both Location and Doctor options cannot be selected.

2. Select the options you want to print on the report:

   • In the Report Dates section, select from a variety of predefined dates. You can choose to print the report based on the Date Claim Was Printed or the Date Claim Was Entered.
     
     Use the drop-down list to display the date range selections: All Dates, Month to Date, Quarter to Date, Last Month, Last Quarter, Last Year and Custom Date. If the range of dates you want to include is not available in the predefined list, select Custom Date and type the date range for your report.

   • In the Include on Report section, you can include Printed Claims and/or Unprinted Claims on the report by selecting the options. Unprinted claims are only available if you select the Date Claim Was Entered option in the Report Dates section.

   • In the Location section, select an option to print a list of patient claims for All Locations or for a Single Location. If you click the Single Location option, select the office from the list that is displayed.

   • In the Doctor section, select an option to print a list of patient claims for All Doctors or for a Single Doctor. If you click the Single Doctor option, select the doctor from the list that is displayed.

   • In the Report Type section, specify the kind of patient claim you want on your report (Pre-Authorization, Actual, One-Time, and Continuation of Treatment.) Pre-authorization claims are divided into Approved and Unapproved. Continuation of Treatment claims are divided into All, Generated, Ungenerated, and Missing Information.

3. After choosing the appropriate selections for the claim report, click Print. The Print Options window is displayed.

Select the Print Report, Preview Report (view on screen), or Export Contents option. You can also change the selected printer from this window. Click OK.

The basic information included on Pre-Authorization, One-Time, Actual, and Continuation of Treatment claim reports is the same:

• Patient name

• Policy holder (responsible party)

• Insurance carrier

• When the claim was entered or printed (depending on the selection you made in the Report Dates section)

• Employer (except for the Continuation of Treatment reports)

• An asterisk (*) before the carrier name indicates the carrier processes electronic claims. A lowercase “e” before the patient’s name indicates that the claim is electronic.

Related Topics

Using Claim Reports Effectively