View the Worklist Summary

The Worklist Summary displays, by product, the billed charges, expected and actual payments, expected and actual discounts, and discount variance for accounts according to your selection criteria. You can select a Worklist Summary for all products or for a specific product.

Field Descriptions

The following table describes each of the fields on the Worklist Summary for All Products page. The fields are sorted by section and listed in alphabetical order.

Field	Description
Submitted Criteria
______ Date	Date range for your query. The type of date that displays is determined by your selection in the Date Type field. For example, if you selected “Submit Date,” this field displays as “Submit Date” and shows the selected date range.
Account Category	Types of account(s) to search for
Contract	Name of the contract profile
Flag Display	Whether or not flagged accounts are shown
Patient Type	Patient type assigned to the account: Inpatient/Outpatient
Payor Class	Payor class associated with the account, either Primary, Secondary, or Tertiary. This option is only available if COB is enabled for your facility. For more information about COB, refer to Coordination of Benefits.
Plan Ids	Plan IDs included in the worklist
Product	Name of the insurance product
Service To Date	Date range for claim Service To dates
Sorted By	Order in which the results are sorted
Optional Submitted Criteria
Additional Amount	Specifies the criteria of (greater than, less than or equal to) account balance, actual discount, actual payment, expected discount, insurance payment, billed charges or patient payment AND/OR (greater than, less than or equal to another amount)
Bill Type	Specifics 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, refer to “Bill Types” on page 1932.
Day Filter	Indicates the type of day filter selected as search criteria and the parameters defined for that filter, such as “Days to Payment Greater than 30 Days.” The available day filters include the following: Days to Payment – The difference between the submit date of the claim and the date of the initial payment Days Outstanding – The difference between the submit date of the claim and today’s date Length of Stay – The length of stay for the claim, in days
Denial Amount	The criteria of (greater than, less than, or equal to) the denial amount. This field only displays if your facility is set up for Contract Manager Denial Management. For more information, refer to Denial Management Methodologies.
Denial Resolution	The specific denial resolutions included in the search; options include All, Resolved, and Open. This field only displays if your facility is set up for Contract Manager Denial Management. For more information, refer to Denial Management Methodologies.
Denial Type	Specifies the type of denials included in the search; options include All, Final, Information, Pending, and Review. This field only displays if your facility is set up for Contract Manager Denial Management. For more information, refer to Denial Management Methodologies.
Denials	Indicates whether accounts that were identified as denials by FinThrive Denials Management were included in the results. Options include Denial Accounts Only and Non-Denial Accounts. This field only displays if your facility is set up for Integrated Denial Management. For more information, refer to Denial Management Methodologies.
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 (Highest Value)	Includes or excludes the specified DRG/APC/CMG codes with the highest value
Exclude Stop Caps	Indicates whether 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.
Exclude Stop Losses	Indicates whether accounts identified as meeting the stop loss threshold were excluded. 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.
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	Indicates whether your results were limited to accounts with a late payment penalty applied. The rules defining late payment penalties are defined in the contract profile.
Opportunity Type	Specifies whether accounts where the expected reimbursement was capped were included in the search. Options include the following: All - Includes all accounts, regardless of opportunity type Contract - Reimbursement was capped based on the Stop Cap section in the contract Line Item - Reimbursement was capped based on the line item Not Capped - Reimbursement was not capped Contract or Line Item - Reimbursement was capped based on either the Stop Cap section in the contract or the line item Contract and Line Item - Reimbursement was capped based on the Stop Cap section in the contract and the line item
Other Codes	Other codes selected, using the Extended Search option
Patient Liability	Specifies whether patient liability amounts were included in the search
Payment Ratios	Specifies an expected or actual payment-to-charge ratio of greater than, less than or equal to a certain amount AND/OR (greater than, less than or equal to) another amount
Production Status	Contract production status
RA Claim Status	Specifies the RA claim status included in or excluded from the search. This option is only available if your facility uses the Remittance Advice (RA) feature. For a description of each RA claim status, refer to Remittance Advice Status Codes.
RA Payment Code	Specifies the RA payment code(s) included in the search. This option is only available if your facility uses the Remittance Advice (RA) feature. For a description of each RA payment code, refer to Remittance Advice Reason Codes and Remittance Advice Remark Codes.
Recurring O/P	Specifies whether recurring outpatients were included in the search
Secondary Payor	An insurance policy, plan, or program that pays an additional amount on the portion of a claim not paid by the primary payor
Service Type	Limits the worklist to a specific service type using the following parameters: equal to, not equal to, starts with, ends with, contains, does not start with, does not end with, or does not contain
Sort By	Allows you to specify the name of the column you want to sort your results by
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.
User Code History	Allows you to find accounts that have historically had the selected FinThrive or Client (customer) user code associated with them (currently or previously)
User Comment History	Allows you to find accounts based on the text included in any user comment associated with the account
Variance Amount	Specifies a discount or payment variance in relationship to (greater than, less than or equal to) a dollar amount or a percentage
Variance By	Type of account variance employed in the search
Variance Percent	Specifies a percentage of variance in relationship to a dollar amount or a percentage
Results Area
Actual Discount	Total insurance adjustments for all accounts; Explanation of Benefits (EOB) write-off
Billed Charges	The total charges billed 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
Product	Name of the insurance product
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.
Total Accounts	The number of accounts included in the summary results for the product
Total Expected Payments	The calculated reimbursement based on the predefined contract terms and conditions and service type definitions in the system and the repriced claims data
Total Payments	The total insurance and patient payments posted to the accounts, as defined in the data