Client Share Report

The Client Share Report shows all insurance payments and patient responsibility adjustments within a specific date range. It provides information on patients, practices, facilities, and claims, including charges, covered amount, payment amount, total paid to the patient, total applied to the deductible, total applied to co-insurance, and total applied to co-pay. It also includes a cumulative total of all patient responsibilities.

Generating the Report

Let's review how to create the Client Share Report report! 

• • 1. Navigate to the Reporting section.
    2. Under Billing Reports, select Client Share Report.
       
       
    3. Update the filters to instruct the system on how to generate the report.
       
    4. Select Run Report.
       
    5. To download the report, select Download.
       
       
    6. To include data from the last 24 hours, select Refresh Data.
       

Available Filters and Definitions

• The Selected Practices filter allows users to filter search results based on the practice that claims were submitted under.
  
• The Start Date and End Date establish a timeframe for the system to locate and include qualifying claims. The output will include any Claim with a closed date in the time frame selected.
  
• Selecting Include Legacy Claims directs the system to generate the report with claims not originally submitted in Avea.
  

Viewing the Report

The Client Share Report provides a comprehensive look at a patient's responsibility, broken down by claim. To view an example of this report, click here. Let's review how the system identifies and calculates patient responsibility! 

Calculations

• Covered Amount: This is the sum of the payments Paid-to-the-Facility + Patient Responsibility. 
• Patient Responsibility (Client Share): this is the Deductible + Co-Insurance + Co-Pay + Additional 
• Out-of-Network (OON) charges.
• Additional Out-of-Network (OON) charges:  This is the sum of all PR adjustment codes and any OA adjustment numbered 100 and above. 
• Non-Covered Charges: The report will not include PI, OA+<100, CR, or CO adjustments.

Columns and Definitions/Locations

Row Name	Definition/Location
Claim Source	This is the origin of the claim.
Practice	Patient > Treatment Episode
Facility	Patient > Services
Patient Name and Patient ID.	Patient > Profile
MRN	Patient > Treatment Episode > Intake > Patient Profile
Closed Date, Claim ID, DOS Start, DOS End.	Patient > Treatment Episode > Insurance Billing > Claims
Units, Service, Charges.	Claim ID > Work Claim > Instances > Control Number > Details > Line Item
Covered, Paid to Facility, Paid to Patient, Deductible, Co-Insurance, Co-Pay,  Add'l/OON, Client Share (Patient Responsibility).	Claim ID > Work Claim > Payments > Check Number > Details

FAQ

• This report is best used when a user wants to know how much insurance is applying to patient responsibility over a given time period. The percentage of patient responsibility against charge amount can be quickly calculated to see if the patient share is in within the expected range

Helpful Hints

• Hover your cursor over time stamp below the Totals section to see the last time data was refreshed
  
• Reports can also be found under the Records Center > Documents > Managing Organization Documents for download.
• You can click on any claim ID hyperlink to be routed to that claim page. There, you’ll be able to review the claim notes and payment information to view how the payment was applied.

• Client Share Report - Demo.xlsx 10 KB