Using the Delinquent Insurance Claim Contact Expert

The Delinquent Insurance Claim Contact Expert is used to search for insurance claims that have not been paid. This Contact Expert should be run daily or when your Office Expert prompts you to so that you can contact the insurance company, the insured party, or resubmit the claims, if necessary.

The most common uses for the Delinquent Insurance Claim Contact Expert are to:

Generate a list of outstanding claims so that you can contact the insured party or insurance company.
Contact insurance companies or insured parties by phone or resubmit claims.
Make notes about an attempted contact and establish a follow-up date in case the claim is not resolved within a time period you specify.

To launch the Delinquent Insurance Claim Contact Expert:

From the Experts menu, select Contact Expert > Outstanding insurance claims. The criteria entry window is displayed.
Enter your search criteria for the following variables:

Number of days outstanding for paper claims
Number of days outstanding for electronic claims
Whether to include claims for which contacts were previously made
Production owner
Types of claims to include

Click OK. After the search is complete, the Delinquent Insurance Claim Contact Expert window is displayed. You can sort the list by column.

When you select entries in the list, the bottom half of the window displays the details of the currently highlighted entry. Click Actions to choose whether to apply the action to the entire list, or to the selected record.

You can click Auto dial to access the on-screen dialer to phone the insurance company. You can use the other buttons to view information about the insured party, the applicable insurance plan, and information about the patient’s claim.

The Contact information area displays the date of the last contact for the selected patient. Click Contacted to access the New Contact Entry window. The Resubmit and Clear claim buttons can also be used to take action on the selected claim.

If you check the Show only claim contacts option in the New Contract Entry window, you can limit the type of comments that are shown to those that deal with claim contact information only.
If you enter a Re-contact if no action by date in the New Contact Entry window, the patient for whom the date has been set is excluded from any future Insurance Claim Contact Experts as well as the Office Expert. To list these patients on your next Insurance Claim Contact Expert, select the Include patients already contacted option in the Insurance Claim Contact Expert Criteria window.