Select Worklist Fields to Export (Master and Payor)

Use this procedure to select fields to export from the Master Account Worklist or Payor Worklist.

  • This procedure explains the process of selecting fields for a Master Account or Payor Worklist. For more information about selecting fields for an Account Worklist, refer to Select Account Worklist Fields to Export.
  • The Payor Worklist is only available if Coordination of Benefits (COB) is enabled for your facility. For more information about COB, refer to Coordination of Benefits.
  1. Access the Select Worklist Fields to Export page:
    • Go To > Account Research > from Worklist. The Account Worklist Criteria page opens.
    • From the Task list, select Create Master Account Worklist or Create Payor Worklist.
    • Specify other selection criteria and click Display Accounts. The worklist opens. For more information about search criteria, refer to Specify Account Worklist Criteria.
    • Select Custom Selection from the Export Fields list and click Custom. The Select Worklist Fields to Export page opens.
  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

Charges

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

Discount Variance

Expected Discount minus the Actual Discount

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)

Insurance Payment

The amount paid by the insurance company

Model Name

Name of the model associated with the account. This option only displays if you are exporting a Master Account Worklist in Audit mode and selected Model as your filter 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.

Other Adjustments

Other, non-insurance adjustments

Patient 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

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.

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