View the Patient Account Audit Page

1. Access the Patient Account Audit page.

   If you know the account number:

   • Select Go To > Account Research > By Account Number. The Account Research by Account Number page opens.
   • Type the account number and click Display Account. The Patient Account Audit page opens.

   If you do not know the account number:

• Select Go To > Account Research > from Worklist. The Account Research from Worklist page opens.
• From the Task list, select Create Worklist.
• Specify other selection criteria and click Display Accounts. The Account Worklist page opens. For more information about search criteria, refer to Specify Account Worklist Criteria.

  Note: PEM claims are not included in worklist results.

• Click the account number you want to review in the Account Number column. The Patient Account Audit page opens.
2. Review the account information.

   When viewing details for secondary and tertiary payors, the amounts shown in results grid at the bottom of the page reflect contractual values as though this payor were the primary payor. These values do not reflect the application of the Coordination of Benefits language. Refer to the Payor Summary section to see the expected payment based on the Coordination of Benefits language.”

3. To change the types of claims that display on this page, select one of the following options from the Claims to Display list.
   • Select All to view all claims for this account.
   • Select Repriced Only to only view claims for this account that have been repriced.
   • Select Not Repriced to only view claims for this account that have not yet been repriced.

     Note: When you select a value from the Claims to Display list, your selection becomes the default value for this field the next time you access the Patient Account Audit page.

4. To view another reprice record associated with this account number, select the reprice you want to view from the Additional Reprice list. The reprice details display in the Reprice Summary section.
   • This field only displays if there are multiple reprices associated with the account number.
5. To view reprice information for additional payors, select Primary, Secondary, or Tertiary from the Additional Payors list. The Payor Summary, Reprice Summary, and the grid at the bottom of the page update with the information for the selected payor.
   • This field only displays if Coordination of Benefits (COB) is enabled for your facility and there are multiple payors associated with the account number. For more information about COB, refer to Coordination of Benefits.
   • The information that displays for a secondary or tertiary payor in the Payor Summary reflects calculations after COB language is applied. Information in the Reprice Summary and the grid at the bottom of the page displays as if that payor was repriced as primary, prior to the application of Coordination of Benefits language.
6. To view additional details regarding the information in the summary sections:
   • Click a Bill Type link. The Billing Type Definition page opens. For more information, refer to Billing Type Definition.
   • Click the Total Expected Payment link, if available. The Expected Payment Detail page opens. For more information, refer to View the Expected Payment Detail.
   • Click the Patient Liability link. The Patient Liability Override page opens. For more information, refer to Override Patient Liability.
   • Click the Write-Off Discount link, if available. The Account Write-Down Detail page opens. For more information, refer to View the Account Write-Down Detail. This link might not pertain to your facility.
   • Click the Late Charge Status link, if available. The Late Charge Alternate Calculation Override page opens. For more information, refer to Override the Late Charge Status.
   • Click the Coordination of Benefits Language link, if available. This field only displays if Coordination of Benefits (COB) is enabled for your facility and you are viewing a secondary or tertiary payor. The Coordination of Benefits Language Definition page opens. For more information, refer to View the COB Language Definition.
   • The following links are available in the Master Account Summary section:
   • Click A/R to access the Payments and Adjustments page for this account at the master account level. For more information, refer to View Payments and Adjustments.
   • Click CHGS to access the Detail Line Item Charges page for this account at the master account level. For more information, refer to View Detail Line Item Charges.
7. To calculate a secondary reimbursement, click Reprice Comparison. For more information, refer to Calculate Reimbursement.
   • Access to this button is dependent upon your user ID.
   • This button is not available if Coordination of Benefits (COB) is enabled for your facility and you are viewing a reprice summary for a secondary or tertiary payor.
8. To view additional details regarding the information in the results table at the bottom of the page:
   • Click A/R in the View column to access the Payments and Adjustments page. For more information, refer to View Payments and Adjustments.
   • Click CHGS in the View column to access the Detail Line Item Charges page. For more information, refer to View Detail Line Item Charges.
   • Click RA in the View column to access the Remittance Advice Lookup page. For more information, refer to Lookup Remittance Advice Data.

     Note: This link only displays if the RA feature is turned on for your facility and there is RA data available for the account.

   • Click UB in the View column to access the UB Representation page. For more information, refer to View the UB-92 Representation.
   • Click CONT in the View column to access the View Contract Profile page. For more information, refer to View a Contract Profile.
   • Click REIM in the View column to access the Expected Reimbursement Detail page. For more information, refer to View the Expected Reimbursement Details.

     Note: The REIM link is disabled for any account that is included in a PEM claim.

   • Click a link in the DRG/APC/CMG column to view a description of the listed code.
   • Click a link in the Message Code column to view a description of the listed message code.
9. To view available denials for this account, click the View Account Denials link.
   • This link is only available if your facility is set up for denial management and there is denial information associated with this account.
   • If your facility is using the Contract Manager Denial Management feature, the Account Denials page opens. For more information, refer to View Account Denial Information.
   • If your facility is using the Integrated Denials Management feature, the Account Denials (Imported) page opens. For more information, refer to Manage Imported Denials.
   • For more information about the available denial management features, refer to Denial Management Methodologies.
10. To flag an account, click Flag Account. The Assign/Update Collection Information page opens. For more information refer to Assign/Update Collection Information.
    • If the account is flagged for collections, the flag information displays in the Comments section at the bottom of the page.
    • If there are multiple comments associated with the account, all comments display in this section.
    • If you select another reprice from the Additional Reprice list, the Comments section is updated with the comments for the selected reprice.
    • To hide the Comments section, click the green minus sign (-) next to the Comments section header.
    • To expand the Comments section, click the green plus sign (+) next to the Comments section header.
11. To research a different account, type the account number in the Account Number field at the bottom of the page and click Display Account.

The following table describes each of the fields on the Patient Account Audit page. The fields are listed in alphabetical order.

For detailed descriptions of the summary sections, refer to the following:

• Patient Summary
• Master Account Summary
• Payor Summary
• Reprice Summary

• Master Account Audit displays the Master Account Audit page. For more information, refer to View the Master Account Audit Page.
• View Supplemental Billing History (if applicable to your facility) displays the Supplemental Billing History by Account page. For more information, refer to Specify Supplemental Billing Account Research Criteria.
• Add Reminder displays the Add/Update Reminder page. For more information, refer to Add or Update a Reminder.
• Add Communication Log Item displays the Add Item page. For more information, refer to Add a Communication Item. This link only displays if your facility is NOT using the Community Portal to create new communication items.
• View Mother’s/Baby’s Information allows you to switch between the Mother’s account information and the baby’s account information within the Patient Account Audit page for maternity related accounts.
  • This link only displays if your facility associates mother and baby accounts together and you are viewing a mother’s account or baby’s account.
  • If the baby’s charges were sent on a UB and have been successfully repriced, the baby’s account displays in the Patient Account Audit page.
  • If the baby’s charges were not sent on a UB or have not been repriced, the Mother and Baby Information page opens. This page also opens if there are multiple baby accounts associated with the mother’s account so you can select the account you want to review. For more information, refer to View the Mother and Baby Information.
• Add Account Override displays the Add Account Override page. For more information, refer to Add Account Override Data.
• Account Override History displays the Account Override History page. For more information, refer to View Account Override History.
• Add Claim Override displays the Add Claim Override page. For more information, refer to Add Claim Override Data.
• View Claim Override History displays the Claim Override History page. For more information, refer to View Claim Override History.
• Add Medicare Override displays the Add Medicare Override page. For more information, refer to Specify a Claim to Override with Medicare Data.