Claim Billing Report

  • Updated

The Claim Billing Report displays claim submission information at the line-item level. It also mirrors the Work Center > Work Claims area in a way that users can manage claim follow-up from a report with workflow information such as status, queue, and assigned user.

Creating The Report

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

Date Type - Service Start, Service End, and Submitted

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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.

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 Claim with a service start, service end, or submitted date in the time-frame selected, depending on the Date Type selected.

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Display Claim State - 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.

 

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

Organization Level - Report data will display in AveaOffice with the option to download a CSV that can be viewed in Excel. This in-app 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.

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Reports can also be found under the Records Center > Documents > Managing Organization Documents for download.

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Results

The Claim Billing Report produces a table where each row represents a claim with a service start, service end, or submitted date within the time-frame specified. 

The Organization level in-browser view and CSV report will display the following columns. The Managing Organization level will include an Organization column in addition to the below columns. 

Report Columns
Practice | Patient | MRN | Payer Name | Insurance ID | Group Number | Date of Service Start | Date of Service End | Claim State | Claim Status | Claim Queue | Claim ID | Claim Sequence | Claim Version | First Submitted Date | Submitted Date | Total Claim Amount Charged | Line Item (LI) Service Date Start | Line Item (LI) Service Date End | Line Item (LI) Units | line Item (LI) Unit Rate | Line Item (LI) Amount | Line Item (LI) Rev Code | Line Item (LI) Procedure Code | Line Item (LI) Service Name | Latest | Assigned User

Totals: Totals are displayed at the top of the in-app display and on the last row of the downloaded report.

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Use Cases

Use the Claim Billing Report when analyzing claim line item details, claim management, and workflow.

FAQ

What is the difference between the Claim Submission Report and the Claim Billing Report?

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.

Tips and Tricks

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

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