Select Account Worklist Fields to Export

Use this procedure to select fields from the account worklist to export.

Note: This procedure explains the process of selecting fields for an Account Worklist. For more information about selecting fields for a Master Account or Payor Worklist, refer to Select Worklist Fields to Export (Master and Payor).

  1. Access the Select Worklist Fields to Export page:
    • Go To > Account Research > from Worklist to open the Account Worklist Criteria page.
    • Select View Summary Results from the task drop down list.
    • Specify and select the appropriate criteria.
    • Click Display Accounts to open the Worklist Summary page.
    • Click a link in the Account Totals column to open the Account Worklist page.
    • Click Export and the Account Worklist Export Options page opens.
    • Select Custom Selection from the Export Fields list and click Custom to open the Select Worklist Fields to Export page.
  2. Select the check boxes for the fields you want to include in the export.
  3. Optionally, you can perform one of the following actions:
    • Click Save Settings to save the custom fields for future use.
    • Click Select All to select every field on the list.
    • Click Deselect All to deselect any fields selected.
  4. Click Submit Fields. The Account Worklist Export Options page opens. For more information, refer to Specify Account Worklist Export Options.

The following table describes each of the fields on the Select Worklist Fields to Export page. The fields are listed in alphabetical order.

Note: Some selections, such as Payor Name, might not populate upon export, depending on your facility setup.

Field

Description

Account Balance

Billed Charges, minus total payments, minus total adjustments

Actual Discount

Total insurance adjustments for all accounts; Explanation of Benefits (EOB) write-off

Admit Date

Date of admission for the account

Bill Type

Displays the 3 digit code displayed on a UB that provides specific information about the intent of the claim. The first digit describes the type of facility, the second digit classifies the type of care being billed, and the third digit indicates the sequence of the bill for a specific episode of care. For example: 117 stands for an acute care facility - inpatient - replacement of a prior claim. To view bill type digit information, see the Bill Type help topic.

Billed Charges

The total charges incurred for the claim or set of claims that have been repriced

Certificate ID

Certification SSN-HIC of the primary payor

Claim Number

Claim number associated with the account. This selection may create duplicate rows for patient numbers that have multiple claims associated with that patient number.

Comment

Comments concerning the account, contract, issue, invoice, quote or negotiation.

Contract Profile

The name of the contract profile associated with the account.

Contract Opportunity

The cap amount where reimbursement was capped based on the Stop Cap section in the contract. The Opportunity Summary section only displays if there is a contract or line item cap amount associated with the account.

Days Outstanding

Number of days past the overdue date. The difference between subdate and today’s date.

Days to Initial Payment

From the most recent UB, the difference between earliest submit date and first paid date

Discount Variance

Expected Discount minus the Actual Discount

Discharge Status

Specifies where the patient is physically located at the time of discharge or where the patient is located at the end of the billing cycle. When selecting the search criteria for your worklist, you can enter multiple discharge status codes separating each code with a comma.

DRG/APC/CMG

Diagnosis Related Group

DRG Severity Code

The Severity of Illness code value for the DRG

Expected Discount

Billed Charges minus non-covered charges, minus Total Expected Reimbursement

Expected Insurance Payment

The calculated reimbursement based on the predefined contract terms and conditions and service type definitions in the system and the repriced claims data, minus patient liability

Expected PCR%

Expected Payment-to-Charge ratio (Expected Payment divided by Billed Charges, times 100)

Financial Class

Financial class code

First Claim Date

Date of the first claim

First Payment Date

Date of the first payment

Flagged

Specifies flagged or unflagged accounts

Insurance Payment

The amount paid by the insurance company

Last Claim Date

Date of the last claim

Last Payment Date

Date of the last payment from the insurance company

Late Charge Alternate Calculation

The amount of the expected reimbursement if you resubmit the claim and include the late charges associated with the claim on the resubmission. This column only displays if you selected Late Charge Alt Calc in the Additional Amount field on the Account Research from Worklist page.

Late Charge Alternate Variance

The variance between the original total expected payments and the late charge alternate calculation. This column only displays if you selected Late Charge Alt Calc in the Additional Amount field on the Account Research from Worklist page.

Late Payment Penalty

The dollar amount of the late payment penalties calculated for the account. The rules defining late payment penalties are defined in the contract profile.

Latest FinThrive Processing Date

Date range for the latest FinThrive processing date for the selected claims

Length of Stay

Length of stay, in days

Line Item Opportunity

The cap amount where reimbursement was capped based on the line item. The Opportunity Summary section only displays if there is a contract or line item cap amount associated with the account.

FinThrive Comment

FinThrive comment

FinThrive Posted By

FinThrive posted by

FinThrive Posted On

FinThrive posted on

Medicare Outlier Date

The date on which Medicare Inpatient claims reach the outlier threshold, based on detail charges

Message Code

Exception message code (a link to the message code description)

No.

Sequential reference number of the line item. An asterisk (*) appears for an account to which an override was applied and the reprice was completed

No. of Accounts

Number of accounts associated with a master account.

No. of Payors

Number of payors associated with an account. This option only displays if Coordination of Benefits (COB) is enabled for your facility. For more information about COB, refer to Coordination of Benefits.

Non-covered Charges

The amount of non-covered charges (not disallowed charges)

Other Adjustments

Other, non-insurance adjustments

Patient Account Number

Patient account number (for UB claims) or insured ID (for CMS-1500 claims)

Patient Liability

The amount the patient is responsible for paying on the account

Patient Name

Patient name

Patient Payment

Portion paid by the patient

Patient Type

Patient type assigned to the account: Inpatient/Outpatient

Payment Variance

Specifies a payment variance in relationship to (greater than, less than or equal to) a dollar amount or a percentage

Payor Class

Indicates whether this account is for a Primary, Secondary, or Tertiary payor. This column only displays if Coordination of Benefits (COB) is enabled for your facility. For more information, refer to Coordination of Benefits.

Payor Code

Payor code associated with the product

Payor Name

Name of the payor

Plan Name

Name of the coverage plan(s) included on claims in the patient list

Posted By

Name of the person that posted the claim

Posted On

Date that the claim was posted

Profitability

The profitability amount associated with this account. The profitability is calculated as the Expected Payment minus Cost.

  • Negative values display in red with parentheses.
  • The Profitability column only displays if your facility has a cost accounting system that sends Contract Manager cost on either a CDM or case level, and the cost and profitability feature has been activated for your facility. For more information, refer to Cost and Profitability Information.

Reprice Type

The reason the claim was repriced separately from other claims for this account. This column also helps to distinguish between multiple claims on an account. For more information about reprice types, refer to Multiple Reimbursement Calculations > Reprice Types.

Service From Date

First date of service rendered to the patient

Service To Date

Date range for claim Service To dates, in the format M/D/YY, MM/DD/YYYY or YYYYMMDD

Service Type

Service type code

Stop Cap

Indicates whether your results were limited to accounts identified as meeting the stop cap threshold. Stop cap is a clause in a contract/proposal that adjusts the reimbursement of claims with low charges and high reimbursement. Stop cap accounts are indicated by a (c) in the Service type column of the results.

Stop Loss

Indicates whether your results were limited to accounts identified as meeting the stop loss threshold. Stop loss is a clause in the contract/profile that adjusts the reimbursement of claims with unusually high charges or lengths of stay. The contract/proposal sets a condition based on a threshold of charges or days. Stop loss accounts are indicated by a (s) in the Service type column of the results.

Total Cost

The total cost amount associated with this account.

  • Negative values display in red with parentheses.
  • The Total Cost value only displays if your facility has a cost accounting system that sends Contract Manager cost on either a CDM or case level, and the cost and profitability feature has been activated for your facility. For more information, refer to Cost and Profitability Information.

Total Expected Payment

The calculated reimbursement based on the predefined contract terms and conditions and service type definitions in the system and the repriced claims data

Total Payment

The total insurance and patient payments posted to the accounts, as defined in the data

User Code

User-defined code; four digit maximum