Identifying Claims for Write-Off Using Claim Status Report

Using AveaOffice's claim status tags and recommended workflow, you can identify claim charges that your accounting team can write off for amounts that will not be collected.

In this article, we'll cover how to create the statuses, run the report, and other workflow considerations.

Prerequisite Configuration

To set your team up for success, first, you'll need to: 

• Add write-off specific claim statuses in Managing Org Admin > Configuration > Claim Status Types.
  • Examples of these statuses could be "Closed - Write-Off", or being specific about certain write-off reasons like "Closed - Appeals Exhausted" or "Closed - Adjustment to Scholarship".
• Train the collection team to select the correct claim status when closing the claim.

How to Build the Report

The Claim Status Report (By Claim) is the best report to run for identifying claims that have been tagged with a claim status associated​ with a write-off reason. Run the report at the Managing Organization level to see information from all organizations under the managing organization.

The image below highlights the columns recommended to gather data for this purpose. The recommended columns are:

• Patient Name
• DOS Start
• DOS End
• Service
• Units
• Claim ID
• Claim Payer(s)
• Submitted Date
• Charges
• Expected Amount
• Difference Covered vs Expected
• Claim State
• Claim Status
• Claim Queue
• Last Action Date
• Date(s) Paid
• Paid Amounts
• Paid to Patient
• Patient Share

The report will show:

• Open or closed claims with dates of service billed within the date range.
• Details on charges, expected amounts, and payments (if any should be posted)
• Filters by Claim Status to only display those of a write-off type
• Last Action Date so you can see the last time an action was taken on the claim

Once the report is filtered, your accounting team can determine the write-off amount by the claim's charges or expected amount.

If data (i.e. payments) related to the claim should change, you can compare claims on each newly generated report.

Tips for Recurring Use

Create a template with the recommended columns so it can be quickly selected and run. This avoids having to manually select the columns each time. 

The Report will run for all practices by default, so allow for a longer run time and wider date ranges over time.

The report will be emailed to the requesting user and a copy of the report will be stored in the Records Center so anyone on your team can download it at a later date.

There is an option to download a CSV instead of Excel file if your accounting team would prefer, in order to upload it into accounting software, like Quickbooks. If a CSV is preferred, please email [e-mail] to activate this feature.

Workflow Considerations

1. Write-off statuses will need to be created for the Managing Organization and tagged at the time the claim is closed.
2. If a claim is closed before an insurance payment is posted, it will not create a patient responsibility billable.
3.  If a claim is closed, then a payment comes in, it will reopen the claim
   • • The claim state will update to Open.
     • The claim queue will update to Review.
     • The claim status will not change.
     • This will assign the claim to the Review queue for payment review. Your team should keep an eye on the Claim Status to know if it was previously closed for write-off.
4.  If a reopened claim is then closed following a new payment, it will create a patient responsibility billable instead of allowing for a hard re-close.
   • If the charges are adjusted off by the payer and not allocated to patient responsibility (without PR code), then the patient responsibility billable will display a $0 balance and automatically close upon approval. 
   • If the charges are adjusted with a PR code, then the billable will need to be approved and manually closed after approval by choosing an adjustment reason for the full outstanding PR balance.
5. Regularly running the recommended Claim Status Report will highlight any actions following a re-opened claim due to new payment by the payer. However, this should not impact accounting's write-off processes unless the payer makes a payment against the claim's balance.