Output and Research

There are several auditing checkpoints throughout the loading and modeling process to verify that information is processing correctly. After executing a model document, you can view the results in several ways:

Contract Modeling Reports – review the results of an executed model document through standardized summary reports. The three available reports are:

• Patient Account Summary
• Revenue Summary by Patient Type
• Revenue Summary by Service Type

Account Worklist - Audit Mode (Go To > Account Research > from Worklist) – query and research repriced accounts (claims). The Account Worklist offers more flexibility for detailed search than do the Contract Modeling reports. Among other details, the Account Worklist shows:

• Account number
• DRG
• Billed charges
• Actual and expected payments
• Suspected underpayments
• Actual and expected discounts

Note: Each account appears as a line item in the worklist, where you can drill down to account details.

Modeling and Analysis (Go To > Modeling and Analysis)–the Modeling and Analysis tool provides summarized information from two perspective

• Contract View – reimbursement by service type.
• Patient View – reimbursement by patient account number.