The Advanced View is an optional view of the data represented in the Revenue Cycle Wheel. The data in this view is grouped into 4 categories: Claim Breakdown by Status, Claim Submissions, New Deposits, and Incomplete Receipts. Clicking on any of the data lines on the left side of the screen will refresh the pie chart to display the data specific to the selected section. This view gives the user an advanced or deeper look into the data directly on the dashboard. Users can quickly see the number and value of claims in any given status, claim submissions that are pending or incomplete, new deposits that are available to be posted, and incomplete receipts that are ready to be worked.
Claim Breakdown by Status
This category shows the user counts and value of all claims in the last 365 days (default user setting) by status broken down into 3 sub-categories.
- Billing - Claims in the Billing group need a user's attention. These claims are either Rejected or Closed - Electronic Superbill. In both cases a user should review the claims. To do so a user only needs to double click on the line. This opens all of the claims in the selected status in the Billing Query screen. Once in the Billing Query screen the user may open the claim, make any necessary changes, and then update the status to one of the Ready to Send statuses.
- Submission - Claims in the Submission group are ready to be billed out to payer or patient. Double clicking on any line will open the Billing Query screen or the Ready to Send Statements screen with the all the claims for the selected status populated. The user may then proceed with the process of Submitting Claims or Submitting Statements depending on the status that was selected.
- Other - Claims in the Other group are claims that have been routed to a specific status based on system configuration. These claims all need to be reviewed by a user. Double clicking on any line with open the selected claims in the Billing Query screen. The user can then review the claim based on the need designated by the claim status the claim is currently assigned to.
Claim Submissions
This category shows the user the status of submissions in the system that require a user's attention broken down into two sub-categories.
- Pending - Submissions in the Pending group are batches of claims that have been created but have not yet been processed or submitted. These claims are sub-grouped by electronic, primary, secondary, and tertiary paper, and statement claims. Double-clicking any line in this group will open the Claim Submission screen or the Statement Batches screen with the data for the selected row. It is from this screen that the user will Process and Submit the Submission.
- Incomplete - Submissions in this group contain claims with potential issues that need to be addressed by the user. The Error sub-group contains claims that have been processed and have an error that have stopped them from being submitted or have been submitted to the payer and have been rejected. The Awaiting Response sub-group contains batches that were sent out but a response was never received from the payer. User verification is required to determine if the batches need to be resent or if they have made it to their destination.
New Deposits
This category shows the user new deposits that are ready to be posted into the system and applied to claims broken down into two groups. Double-clicking either group will open the Deposits screen with the selected deposits displayed.
- ERA - Deposits in the ERA group are deposits that have been downloaded from a clearinghouse or have been imported by a user. Posting ERA Deposits
- Payer - Deposits in the Payer group are deposits that have been manually created by a user. Posting EOB Deposits
Incomplete Receipts
This category shows the user receipts that have been created in the system and now require a user to review them and apply them as necessary broken down into two groups. Double-clicking either group will open the Receipts screen with the selected receipts displayed.
- Error Receipts - Receipts in the Error group are receipts that could not be applied either due to Holding date or because of missing information or a claim to apply it to. A user should review and apply the receipts as necessary.
- Unapplied Receipts - Receipts in the Unapplied group are receipts that have been created and have not yet been fully applied to claims. A user should review and apply the receipts as necessary.
