Partner's insurance billing tools help you work down and monitor your insurance accounts receivable. From generating claims to tracking outstanding balances, Partner helps you maximize the use of your time as you pursue proper reimbursement.
Collecting insurance balances is a big job, but it can be broken down into the steps shown below. Learn more about each of the steps by reading the other sections of this document.
Step One: Generate and Submit Claims
Use Partner's preptags, ECS and hcfa programs to generate electronic and paper claims. Both paper and electronic claim procedures allow you to submit part or all of your outstanding insurance claims while processing for basic errors.
Step Two: Verify Claim Submission
You will receive electronic reports detailing your claim submissions, including logs of any errors or submission problems. Your office should use the ecsreports program to review "Bad Claims" and "Payor Response" reports. Understanding all of the different reports will give you more tools for dealing with an unpaid claim. All electronic reports (whether they are printed or sent to your e-mail box) are stored in the ecsreports program for easy access.
Step Three: Keep Track of Outstanding Claims
Use Partner's reporting features to track your accounts receivable. While Partner has hundreds of reports, a good place to start is with the "Insurance Accounts Receivable Summary" (insaging) report. It will give you a broad view, by insurance group, of where your outstanding balances are focused and how old they are. You can then use the "Insurance Accounts Receivable Detail" (inscoar) report to analyze specific claims based on insurance company, provider, or other criteria.
Step Four: Post the EOB, Submit to the Next Responsible Party
When you receive an EOB or a rejection, you should post it in Partner and link payments and adjustments to each of the referenced charges. This is handled by the Post Insurance Payments program (pip). When you post a $0 payment or payments and adjustments that do not cover the full amount of the charge, you can use pip to immediately fix account problems and resubmit the charges, send them to the next payor, or bill the family.
Step Five: Fix Problems and Recreate Claims
During any of the above steps, perhaps even before you first submit a claim, you may need to fix a problem with a charge and recreate the claim. For example, if you find the account had a new insurance plan or was responsible for a larger copay, you can use the Correct Mistakes (oops) program to change the details of the charge and then re-batch the claim. In some cases, you may have to recreate an entire batch of claims, perhaps for an insurance group that had the wrong company address. The maketags program can re-prepare a large number of claims based on your desired criteria.
Contact PCC support at 1-800-722-1082 if you have any questions about the Partner programs or office procedures described above.