Worklist Suggestion and Examples Content

• Related Articles

• Charge Management Rule Examples

  Alert for Provider Credentialing There is a System delivered Charge Management Rule to display a Validation Warning for Providers who are not yet Credentialed with a Specific Insurance. Use this link for more detailed documentation: Hold Billing for ...

• Denial Worklist Overview

  The Denial Worklist is populated when an ERA is applied, and at least one line item on the Remit has a zero dollar Payment and is statused to DW on the ERA Remit Items screen. The Denial Worklist is interactive with links to the: Encounter Dashboard ...

• Charge Management Action Examples

  Add a Legacy ID in HCFA Box 33b for a Secondary Payer Scenario: BCBSTX is Primary and MagnaCare is Secondary. MagnaCare wants a Legacy ID in Box 33b on the HCFA (Paper Claim), but the Primary, BCBSTX, does not require this. Criteria Select ...

• Worklist Suggestions & Examples

  Appointment Missed Appointment Fee: Added by Front Desk user for biller to add a No Show Fee. Workers Comp: Authorization missing Eligibility Denials Authorizations Encounters Manual Insurance Denials Eligibility Denials Authorizations Missing ...

• Rejections Examples

  Rejection: Invalid Subscriber ID Format for ___ Resolution: From the Patient Dashboard, verify Eligibility, view the Eligibility Report, view the Patient's Scanned Insurance Card, and/or call the Patient. Correct the Policy Number. On the Encounter ...