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Tebra Help Center

Navigate Insurance Collections

Updated: 12/11/2023|Views: 10920

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.
Billing_InsuranceCollections_Access.png

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.
Billing_InsuranceCollections_Navigate.png

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.
Billing_InsuranceCollections_TrackCharges.png
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