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Insurance Claim Aging Report

The Insurance Claim Aging Report displays each insurance carrier with outstanding claims, including the insurance plan name, group plan name, insurance phone number, and group number, and each outstanding insurance claim.

The insurance claim information will include a notation of primary or secondary, the date the claim was sent, the date a tracer was sent, the date the claim was placed on hold, the date the claim was re-sent, the patient name, patient birthday, the subscriber name, subscriber ID number, the estimated insurance payment, and the amount billed to insurance. The amount billed to insurance, the amount that is still outstanding from insurance, or the amount of the estimated insurance portion will be placed in the current, 31 - 60, 61 - 90, or > 180 column, based on how long ago the claim was sent. The primary and secondary claim amounts will each be totaled and displayed, and a combined total will appear at the bottom of the report.

If your clinics have been set up to allow Dentrix Enterprise to mark claims as being closed automatically or to allow you to do it manually, you can filter the report to include only open claims. The clinic setting for allowing the marking of claims as being closed is the Claim Must Be Zero to Close check box in the Clinic Resource Setup dialog box (you must be logged in to the Central clinic to change the status of the option).

To generate the report

1.   In DXOne Reporting, select Ledger, and then double-click Insurance Claims Aging.

The Insurance Claim Aging dialog box appears.

2.   Set up the following options:

·        Insurance Carrier - Click the From and/or To search buttons to select the range of insurance carriers you want to include on the report (the range can be open-ended), or select both All check boxes to include all carriers.

·        Patient - Click the search button to select the range of patients you want to include on the report, or select the All check box to include all patients.

·        Clinic - Click the search button to select the clinics you want to include on the report, or select the All check box to include all clinics.

·        Provider - Click the search button to select the providers/staff you want to include on the report, or select the All check box to include all providers and staff/members.

·        Billing Type - Click the search button to select the billing types for patients you want to include on the report, or select the All check box to include all billing types.

·        Patient Tag - To have the report include patients with certain tags assigned to them, select the Run By Patient Tag check box; and then, click the search button  to select the desired patient tags, or select the All check box to include patients with any patient tag. To not filter the report by a patient tag, clear the Run By Patient Tag check box.

·        Minimum Days Past Due - Select the minimum number of days past due a claim must be to be included on the report. Only the claims that have been sent over 0, 30, 60, 90, 120, 150, or 180 days ago will be included on the report. To include all claims, select "Over 0."

·        Insurance Type - Select Dental or Medical to include either of those insurance types on the report.

·        Other Options - Select any of the following options:

·        Show Open Claims Only - Select this check box only if the Claim Must Be Zero to Close check box in the Clinic Resource Setup dialog box is selected. With the Show Open Claims Only check box selected, the report includes only claims that have not been marked as being closed (either automatically or manually). If Dentrix Enterprise cannot close a claim automatically, and if you have not closed the claim manually, the claim is considered to be open even if an insurance payment has been posted and there is not an outstanding amount that is expected from insurance for the claim. With the Show Open Claims Only check box is clear, the report includes claims that have not had any insurance payments posted for them (claims that do not have the Received status).

If the Show Open Claims Only check box is selected, the Age Amount Outstanding instead of Total Billed figure check box becomes available. With the Age Amount Outstanding instead of Total Billed figure check box selected, the amount that is still outstanding from insurance will be placed in the current, 31 - 60, 61 - 90, or > 180 column, based on how long ago the claim was sent. With the check box clear, the amount billed to insurance will be placed in the current, 31 - 60, 61 - 90, or > 180 column, based on how long ago the claim was sent.

·        Age Insurance Estimate instead of Total Billed figure - The amount of the estimated insurance portion will be placed in the current, 31 - 60, 61 - 90, or > 180 column, based on how long ago the claim was sent.

·        Group By Provider of Procedures - With this check box clear, claims on the report are grouped by insurance plan. With this check box selected, claims on the report are grouped by rendering provider and then by insurance plan.

3.   Click Save as Default to save the current settings for the next time you run the report.

4.   Click Clear Defaults to revert the dialog box options to the original defaults.

5.   Click Schedule to schedule a report job.

6.   Click OK to preview the report.