Claim Payments Report

  • Updated

The Claim Payments Report presents users with all payments recorded in a given date range from a summary or detailed view. Being able to see the revenue for an organization or managing organization is a good way to assess collections and cash flow. 

 

Creating the Report

Go to the Reporting section from the left-side menu. This report is available at both the Organization and Managing Organization levels. Under Billing Reports, select Claim Payments Report.

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Organization vs Managing Organization

Organization: Running the report from the Organization level allows the user to select one or more Practices under an Organization and will include all facilities under the selected Practices.
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Managing Organization: Running the report from the Managing Organization level allows the user to select one or more Organizations and will include all Practices and Facilities under the selected Organizations. 

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Report Settings

Report Display Type - Summary or Detail

  • Summary - This displays payment information at the claim level, with all payment lines rolled up to the payment number
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  • Detail - This displays payment information at the payment level, with all payment lines broken out to an individual line.
    In the detailed version, the Claim Status reports as of the time payment was received so you can use excel functions to sum payments received in a particular status in the past. For example, this could be very helpful if you're using statuses to track your appeals efforts which would allow you to estimate the payments received during a given appeals phase, thereby analyzing if the amounts collected are worth the time spent.
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Date Type - Post, Payment, or Deposit
*The date type options differ between the Summary & Detail display type

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  • Post (Default) - Post date of the Payment Collection 
    Reports run by Post date will show all claims with payments posted within the selected date range. This is useful for finding how much new money was recorded during the date range. This field is also helpful for reviewing average monthly collections.
  • Payment - Payment date of the Payment Collection
    Reports run by Payment date will show all payments with a check date within the selected range. This selection isolates payer processing time.
  • Deposit - Deposit date of the Payment Collection
    Deposit Date will only show claims that have a deposit date set within the date range selected. Deposit Date is an optional field for payment collections. Use this field to keep track of what checks are already in their bank account.
  • Service Start (Detail Type Only) - "From Date" of the claim (first date of service listed)
    Service Start will only show claims that have a From Date or first service date line item within the date range selected.
  • Service End (Detail Type Only) - "To Date" of the claim (last date of service listed)
    Service End will only show claims that have a To Date or last service date line item within the date range selected.
  • Submitted (Detail Type Only) - Submitted date of the claim
    Submitted date will only show claims that have a submitted date within the date range selected.

 

Date Range - Start Date & End Date

Start Date and End Date: These two dates determine the date range for which the report is run.
* The output will include any payment with a post, payment, or deposit date OR claim with a service start, service end, or submitted date in the time-frame selected, depending on the Date Type selection.

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Payment Matching Status - Matched, Legacy, Unmatched, and All 

Payment Matching Status refers to where the payment exists in AveaOffice. Use this filter to create a report that only shows payments posted to claims, outstanding payments, or all payments received. 

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  • Matched Claim Payments (Default) - will only display payments that have successfully posted to both AveaOffice or manually created legacy claims.
  • Legacy Payments  - will only display payments that have been marked as legacy. These are payments maintained in the Records Center, but not posted to any claim. 
  • Unmatched Payments  - will only display payments that are In Review. These are payments are loaded in AveaOffice but are not yet matched to a claim or marked as legacy. 
    These can be found in the Work Center under Insurance Payments, in the Review Insurance Payments sub-tab. 
  • All Payments  - will display all of the above payment status.

 

Display Claim State (Detail Type Only) - Closed, Open, Voided, Discontinued, and All 

Claim State refers to the state of the claim at the time the report is run. Choosing an option other than 'All' will return a filtered report of claims with only the selected state.

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  • All (Default) - will include all claims with the available state options
  • Closed - will only display closed claims
  • Open - will only display open claims
  • Voided - will only display claims that have been voided
  • Discontinued (Uncommon) - will only show claims with a discontinued state.
    *A claim is given a state of discontinued when the Practice under which the claim was billed has been deactivated and is no longer available for billing functions.  

 

Payments Display (Detail Type Only) - Only Payments, Without Payments, and Both

Payments Display allows the user to chose whether they want to see claims that have or do not have remittance posted.

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  • Both (Default) - will display all claims that have and do not have remittance posted.
  • Only Payments - will only display claims that have remittance posted (payment/non-payment)
  • Without Payments - will only display claims that do not have remittance posted (no postings)

 

Claim Status Date Type (Detail Type Only) - Current, Post Date, and Payment Date

Claim Status Date Type allows the user to chose whether they want to see claim's status that is currently assigned, or the status at the time of the Post or Payment date.

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  • Current (Default) - will display the current claim status for the claims listed
  • Post Date - will display the claim status as of the date of the post date
  • Payment Date - will display the claim status as of the payment date

 

 

Show Multiday Payments Only (Detail Type Only) - No or Yes toggle setting

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Show Multiday Payments Only has a default setting of 'No'. Toggle this setting to 'Yes" to show only payments that are not itemized (posted as the date range of services rather than to each service line)

It is best practice to ensure that all posted payments and non-payments reflect the service lines of the claim exactly. If the claim is itemized with each service on its own line, then the payment or non-payment should reflect that to ensure correct and expedient processing of a secondary claim.

 

Generating the Report - Run Report, Refresh Data, and Download

Organization Level - report data will display with the option to download a CSV that can be viewed in Excel. This in-browser view allows the user to run the report, then refresh the data without having to run another report.

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  • Run Report - Click Run Report to generate a report using to the selected settings
  • Refresh Data - To improve report speed, report and dashboard data is cached up to the last 24 hours. To use real-time data, click Refresh Data to update reports results using the most recent data.
    Pro Tip: Hover your cursor over time stamp below the Totals section to see the last time data was refreshed
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  • Download - Choose Download to export the report data as CSV. Your CSV file can be opened with Excel or other desktop app

 

Managing Organization Level - Reports will run in the background and a download link will be sent to the requesting user from Avea Solutions.

  1. After clicking Create Report,
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  2.  A message will indicate that the report will be sent to your email to download once it's ready.
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  3. Check your email for a link to the report.
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  4. Reports can also be found under the Records Center > Documents > Managing Organization Documents for download.
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Results

Summary Type produces a table where each row represents a single claim payment as a whole, and each column is a different piece of information about that payment/non-payment.
* Dates of service, Units, Charge amounts and Paid amounts are rolled up to one line.

   Report Columns        
  • Payment Date
  • Post Date
  • Deposit Date
  • Created Date
  • Organization Name
  • Practice Name
  • Facility Name
  • Patient Name
  • Claim Payer
  • Claim ID
  • Sequence
  • Version
  • Service Start Date
  • Service End Date
  • Units
  • Service
  • Revenue Code
  • Procedure Code
  • Bill Type
  • Place of Service
  • Charges
  • Paid To Facility
  • Paid To Patient
  • Interest Paid
  • Total Paid
  • Payment Source
  • Payment Type
  • Check Number
  • Payment Matching Status
  • Claim Source
  • Covered Amount





 

Detail Type produces a table where each row represents each payment line item, and each column is a different piece of information about that payment line item.
* Dates of service, Units, Charge amounts and Paid amounts are broken out to a separate line. 
* Note that the Claim ID, Check Number and other data will repeat on each line.

    Report Columns        
  • Practice
  • Patient
  • MRN
  • Payer Name
  • Home Plan Payer
  • Insurance ID
  • Group Number
  • Date of Service Start
  • Date of Service End
  • Service
  • Units
  • Claim State
  • Claim Status
  • Claim Queue
  • Claim ID
  • Claim Sequence
  • Claim Version
  • Submitted Date
  • Date Paid
  • Payment DOS Start
  • Payment DOS End
  • Line Item Amount Charged
  • Amount Paid
  • Allowed Amount
  • Amount Paid Facility
  • Amount Paid Patient
  • Deductible Amount
  • Coinsurance Amount
  • Copay Amount
  • Interest Paid
  • Post Date
  • Deposit Date
  • Check Number
  • Is Latest
  • Assigned User
  • Revenue Code
  • Procedure Code
  • Bill Type
  • Place of Service
  • Organization
  • Covered Amount


 

 

Totals display differently between Organization level and Managing Organization level reports

Organization Level Totals - Totals are displayed in-browser above the report table & on the final row of the CSV download.

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Managing Organization Level Totals - Totals are displayed on a separate sheet from the report table in the CSV file on the final row of the report table. 

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FAQ

What is the difference between Allowed Amount and Covered Amount?

The Allowed Amount is the maximum amount the plan will pay on the claim. This number is pulled directly from the payment as it displays in AveaOffice. This amount may have been received on an ERA or manually entered by a user when an EOB was received by mail. 
This dollar amount is often calculated by the payer to include the Paid Amount + Deductible (PR 1) + Co-Insurance (PR 2) + Co-Pay (PR 3).

The Covered Amount displays the total amount of billed charges covered by the insurance and is a report calculation that includes Paid Amount + Deductible (PR 1) + Co-Insurance (PR 2) + Co-Pay (PR 3) + Paid to Patient. 

 

What report is recommended to be used by a billing company for invoicing their clients on a % Payments Collected?

The best report for determine the amount of payments collected in a time period would be the Claim Payments report. Billing companies often prefer the Summary version of this report to provide to their clients and will keep the report filtered on Matched Payments only. You'll want to be diligent in your close procedures and payment posting practices to ensure data accuracy since a user can update a payment posted in a prior period. Even if you use the summary version, we recommend you download and save a copy of the detail version; always run it at the same time as the summary so you have the details you need later for any comparisons. 

 

Tips and Tricks

Search

Search by patient name, claim ID, and check number to filter the report without having to download to Excel.

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