Report:  Claims by Payer

 

(Topic Last Updated On:  05/05/2010)

 

This report displays all billing claims submitted using the Claims Generator screen over a selected date range, grouped by the billing provider to whom the claims were submitted.  The patient who received each service, type of service, billing provider, claim start and end date, number of billable units, rate per unit, and dollars claimed are presented for each submitted billing claim.  Totals are provided for each provider, and grand totals are provided for all claims appearing on this report.  This report is generally used by accounting, billing, or administrative personnel, and can be used as an alternative to the Claims by Patient and Claims by Billable Service reports.

 

 

Report Column Explanations

 

Patient ID

This column displays the Patient ID of the patient who received each billable service being claimed.

Patient Name

This column displays the full name of the patient who received each billable service being claimed.

Billing Type

This column displays the type of billable 'Service' provided to the patient for each claim.

Insurance

This column displays the name of each patient's 'Billing Provider', stored for each patient on the Payment Information screen.

Claim Start Date

This column displays the 'Service Start Date' of each billing claim, as generated or entered on the Claims Generator screen.

Claim End Date

This column displays the 'Service End Date' of each billing claim, as generated or entered on the Claims Generator screen.

Units

This column displays the number of billable 'Units' generated or entered for each billing claim on the Claims Generator screen.

Rate

This column displays the 'Rate' charged per billable unit for each billing claim.

Dollars Claimed

This column displays the total dollar amount billed for each billing claim.

 

Report Field Explanations

 

Provider Code

This field serves as a header and displays the name and code of the Billing Provider to which the displayed claims were submitted.

Total Claims for (Provider Code - Billing Provider)

This field displays the total number of billing claims, total number of billable units, and total dollar amount claimed for each billing provider included on the report.

Total Claims for All Providers

This field displays the total number of billing claims, total number of billable units, and total dollar amount claimed for all claims included on the report.

 

Criteria Explanations

 

From Date

This parameter allows users to limit the report's data by displaying only billing claims with a 'Service Start' date on or after the date selected here.

To Date

This parameter allows users to limit the report's data by displaying only billing claims with a 'Service Start' date on or before the date selected here.

Provider Code ID

This parameter allows users to limit the report's data by displaying only billing claims submitted to the 'Billing Provider' selected here.

Service Type

This parameter allows users to limit the report's data by displaying only billing claims of the 'Service' type selected here.