Claim Billing Report

  • Updated

The Claim Billing Report shows detailed claim submission information, including line-item details. It provides a way for users to handle claim follow-up directly from the report, displaying workflow information like status, queue, and assigned user like the Work Center > Work Claims area.

Generating the Report

Let's review how to create the Claim Billing Report! 

      1. Navigate to the Reporting section.
      2. Under Billing Reports, select Claim Billing 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 Date Type instructs the system what claims should be included in the report within the time range set by the Start Date and End date.
    • Service Start (Default) - "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 - "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 - Submitted date of the claim. Submitted date will only show claims that have a submitted date within the date range selected.

  • The Start Date and End Date establish a timeframe for the system to locate and include qualifying claims.
  • The Display Claim State allows a user to include or omit certain based on their current state. These options include:
    • All
    • Closed
    • Discontinued
    • Open
    • Voided

Viewing the Report

The Claim Billing Report generates two tables. The first table displays on the screen and includes the totals for the number of Patients, Claims, Line Units, and the sum of all Line Amounts. Each row on the second table displays represents a claim with a service start, service end, or submitted date within the specified time frame. To view an example of this report, click here

Columns and Definitions

Row Name Location

Practice

Patient 

Patient > Profile

MRN

Patient > Treatment Episode > Intake > Patient Profile

Payer Name

Patient > Treatment Episode > Intake > Insurance

Insurance ID

Group Number

Patient > Treatment Episode > Intake > Insurance > Insurance Set > Policy Holder

Date of Service Start

Date of Service End

Claim State

Claim Status

Claim Queue

 

 

Patient > Treatment Episode > Insurance Billing > Claims

Claim Sequence

Claim Version

First Submitted Date

Submitted Date

Total Claim Amount Charges

 

 

Claim Number > Instances

Line Item (LI):

Service Date Start

Service Date End

Units

Unit Rate 

Amount

Rev Code

Procedure code

 

 

 

Claim Number > Instances > Control Number > Line Items

Latest (version of the claim)

Claim Number > Instances

Assigned User

Patient > Treatment Episode > Insurance Billing > Claims

FAQ

  • The Claim Billing Report includes line-item specific information such as the line item charge amount, unit rate, revenue code, procedure code and service name. The Claim Submission Report does not provide this additional level of detail. The Billing Report also includes workflow columns such as Claim Status, Claim Queue, and Assigned User. You can use the billing report when determining claims to follow-up on and submission information. The Submission Report does not include this information in the report.
  • Use the Claim Billing Report when analyzing claim line item details, claim management, and workflow.

Helpful Hints

Search by patient name or claim ID to filter the report without having to download to Excel.

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