The Missouri Medicaid Cost Report displays cost information (charges, adjustments, and net insurance payments) regarding procedures billed to insurance carriers. The report displays only procedures that are associated with dental claims.
To generate the report
In DXOne Reporting, select Custom, and then double-click Missouri Medicaid Cost Report.
The Missouri Medicaid Cost Report dialog box appears.
Set up the following options:
Date Range - To filter the report by date, do one of the following:
To include procedures on claims that have service dates within a range that you specify, select the Specific Range option. With this option selected, do one of the following:
Enter a date range (in a m/d/yyyy format) in the From and To boxes.
To select a date, do the following for From and To:
Click the corresponding calendar icon to view a month calendar.
Navigate to the correct month, using the left and right arrows.
Note: To quickly change the year and month, click the month-year at the top of the calendar, navigate to the correct year, using the left and right arrows, and then click the correct month.
Click the correct day.
To include procedures on claims that have service dates within a range that is relative to the report date, select the Relative Date Range option. With this option selected, select one of the following relative date ranges from the list:
Current Day Current MTD Current Fiscal YTD Current Calendar YTD |
Previous Day Previous Week Previous Month Previous 3 Months Previous 6 Months Previous Fiscal Year Previous Calendar Year |
Next Day Next Week Next Month Next 3 Months Next 6 Months Next Fiscal Year Next Calendar Year |
Billing Type - To filter the report by the billing types that are associated with patients who have procedures that are attached to claims in their records, do one of the following:
To include all billing types, select the All checkbox.
To include specific billing types, do the following:
Click the search button 
.
The Select Billing Type dialog box appears.
If the list is long, to search for a billing type by ID and/or description, do the following:
Click Search.
The options for searching appear in the upper list.
Enter the first character or more of a billing type's ID and/or description in the ID and Description boxes, respectively.
Click Show Results to view a list of matching billing types.
Note: To return to viewing the list of all the billing types, click Search, click Clear Search to clear the search criteria that you entered, and then click Show Results.
In the upper list, select one or more billing types.
Note: To select multiple billing types, click a billing type, and then, while pressing the Ctrl key, click the other desired billing types. To select a range of adjacent billing types, click the first billing type of the desired range of billing types, and then, while pressing the Shift key, click the last billing type of the desired range of billing types.
Click Add.
Repeat steps b-d as needed to add other billing types.
Note: To not include a billing type that you added, select that billing type in the lower list, and then click Remove.
Click OK.
Patient Tag - Do one of the following:
To not filter the report by a patient tag, clear the Run By Patient Tag checkbox.
To filter the report by the tags that are assigned to patients who have procedures that are attached to claims in their records, select the Run By Patient Tag checkbox. With this checkbox selected, the options to filter the report by tag are available. Do one of the following:
To include patients with any patient tag, select the All checkbox.
To include patients with specific tags, do the following:
Click the search button .
The Patient Tag Selection dialog box appears.
If the list is long, to search for a patient tag, do the following:
Click Search.
The options for searching appear in the upper list.
Enter the first character or more of a patient tag name in the Tag Name box.
Click Show Results to view a list of matching patient tags.
Note: To return to viewing the list of all the patient tags, click Search, click Clear Search to clear the search criteria that you entered, and then click Show Results.
In the upper list, select one or more patient tags.
Note: To select multiple patient tags, click a patient tag, and then, while pressing the Ctrl key, click the other desired patient tags. To select a range of adjacent patient tags, click the first patient tag of the desired range of patient tags, and then, while pressing the Shift key, click the last patient tag of the desired range of patient tags.
Click Add.
Repeat steps b-d as needed to add other patient tags.
Note: To not include a patient tag that you added, select that patient tag in the lower list, and then click Remove.
Click OK.
Other Options - Select or clear the following checkboxes:
Excel Friendly - With this check box selected, the report displays the data in a format that you can easily export to a spreadsheet program. With this checkbox clear, the report displays data in its standard format.
Use Patient Chart Number instead of Name - With this checkbox selected, the report displays the chart number (instead of the first and last name) of each patient. With this checkbox clear, the report displays the first and last name of each patient.
Click Save as Default to save the current settings for the next time you run the report.
Click Clear Defaults to revert the dialog box options to the original defaults.
Click Schedule to schedule a report job.
Click OK to preview the report.
For each procedure on the report, the following details appear:
Clinic Name - The practice title of the clinic.
Clinic NPI - The clinic's NPI.
Patient First Name - The first name of the patient (unless the report is showing chart numbers).
Patient Last Name - The last name of the patient (unless the report is showing chart numbers).
Chart Number - The chart number of the patient (unless the report is showing patient names).
Insurance Claim ID - A unique number that identifies the claim.
Provider - The first and last name of the provider.
Patient Primary Insurance Name - The name of the patient's primary insurance carrier.
Patient Primary Insurance Subscriber # - The subscriber ID for the patient's primary insurance plan.
Patient Secondary Insurance Name - The name of the patient's secondary insurance carrier.
Patient Secondary Insurance Subscriber # - The subscriber ID for the patient's secondary insurance plan.
Patient Tertiary Insurance Name - The name of the patient's tertiary insurance carrier.
Patient Tertiary Insurance Subscriber # - The subscriber ID for the patient's tertiary insurance plan.
Patient Quaternary Insurance Name - The name of the patient's quaternary insurance carrier.
Patient Quaternary Insurance Subscriber # - The subscriber ID for the patient's quaternary insurance plan.
Date of Service - The service date of the procedure.
Procedure Code - The ADA Procedure Code.
Charge - The amount charged for the procedure.
Adjustments - The sum of all credit adjustments associated with the charge.
Net Payment by Primary Payer - The sum of all primary insurance payments associated with the charge.
Net Payment by Secondary Payer - The sum of all secondary insurance payments associated with the charge.
Net Payment by Tertiary Payer - Sum of all tertiary insurance payments associated with the charge.
Net Payment by Quaternary Payer - Sum of all quaternary insurance payments associated with the charge.