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Tebra Help Center

Navigate Insurance Collections

Updated: 12/11/2023|Views: 8435

Users with the System Administrator and/or Biller web role(s) can view Insurance Collections that provide tracking and insight into the status of claims submitted to payers.

Access Insurance Collections

  • Hover over the Billing icon on the top menu and click Insurance Collections. The Insurance Collections page opens and the list of insurance claims for the practice displays.

Navigate Insurance Collections

  • Categories: Click a category on the left menu to view claims by status.
    • All: Selected by default and displays a list of all claims submitted to payers with open balances that are in the responsibility of the insurance company.
    • Rejected: Claims rejected by the payer.
    • Denied: Claims denied by the payer.
    • Waiting for adjudication: Claims waiting on payer response.
    • Needs investigation: Claims without activity for 21 days (electronic claims) or 30 days (paper claims).
  • Filters: Use the drop-down menu options to filter claims within a status.
    • Sort: Defaults to Priority. Click to select Date of Service or Claim Amount. Click once to view ascending order (up arrow displays) or twice for descending order (down arrow displays).
    • Provider: Defaults to All Providers. Click to select an individual provider name.
    • Location: Defaults to All Locations. Click to select an individual practice location.
    • Since: Time frame defaults to Forever. Click to select a different time period.
  • Search: Find a claim by patient name, encounter ID, or insurance name.
  • Claim Details: Displays the date of service, claim ID also known as the patient control number (PCN), patient, provider, total charge amount, number of procedures, payer, and status icon.
    • To track charges, click on the claim and the charges details expand.
  • Claim status icons:
    • The red exclamation icon indicates a denied claim.
    • The yellow exclamation icon indicates a rejected claim.
    • The green arrow icon indicates claim processing is moving forward.
  • Pagination: Click the arrows or page numbers to navigate. Each page displays up to 10 claims.

Track Charges

  • Click the listed claim on the Insurance Collections page. The charges details expand.
    1. Click the arrow to expand and view the Transaction History list for each service line.
    2. A brief description of the charge's latest activity displays above the timeline.
    3. Follow progress of the charge through color coding.
      • Green: Complete
      • Dark gray: In progress
      • Light gray: Not started
    4. Hover over each timeline stage to view the description.
      • Claim submitted by practice
      • Resubmission (rework)
      • Insurance collections (primary)
      • Insurance collections (non-primary)
      • Patient collections
    5. To view the charge capture, click to select the View Charge option from the Actions drop-down menu.
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