How Andre Manages Outstanding Claims in Eaglesoft Without Printing a Report
Many Eaglesoft users rely on the Reports>Insurance>Outstanding Claims by Aging Category or by Insurance Company report when they print many pages of information in order to make calls to carriers to follow up on outstanding claims.
I have found that, without printing any reports, you can use the Process Insurance Claims window (“Claims”) as the best method to audit outstanding claims.
Where is the Process Insurance Claims window? There is a Claims Icon on the tool bar of the Front Office screen.
How do you use it to audit? Click it. With the window open; select from Show What section (upper left) the "Show Primary / Secondary Claims" radio button, From the View section (top center) choose the "Open" selection only. Click the "Days Outstanding" column header twice (which sorts the claims by the oldest first). (see picture) Now you can see claims that over 30 days old. Anything over 30 days needs to be followed up on.
Any Claim over 30 days that is NOT a Secondary claim, should be followed-up. (This is not a “how-to” on how to do follow-ups, but where to find those claims that need to be followed up on.) I do suggest that if there are a “lot” of claims over 45-days, offices highlight them ALL and re-process them. If nothing else, you will get a notification within a few days as to the status of that claims (i.e. previously paid, denied, check went to patient, need more information). I also recommend that offices submit claims TWICE daily. Once at midday, and once as part of the End-of-Day (EOD) processes. There is nothing worse than sending claims at the end of the day only to find that information is “missing” and the claims won’t go through or that there are so many claims that the processing is taking “forever” to go. IF claims are submitted twice daily there should be nothing in your Claims box marked as unsubmitted UNLESS there is something preventing the claim from submission (I.e. Missing SS#).
The Claims window should be reviewed daily. Any claim that rolls over 30 days (that is not a secondary) should be addressed. Also see QUICK TIP: Adding a Statement “Note” When Posting EOBs.
Remember that if you close and resend a claims using SmartClaim you will “renew” the claim and the aging date will update to “today”. Reprocessing the claim keeps the original aging date.
Question: How do I run a report for outstanding insurance claims over a certain dollar amount?
Answer: Go to the claims window and select claims by age. Choose your filters and then you should be able to click on the dollar amount header and the list of claims should sort by dollar amount.
Question: Is there a way to show the Policy Holder’s Social Security Number in the Outstanding Claims report?
Answer: The Policy Holder’s DOB IS visible on the Outstanding Claims report by Ageing Category, but the Policy Holder’s Social Security Number is masked. There is no setting to show this info. If the Employer/Coverage Plan Preferences are set to us Policy Holder Member ID (Primary Member ID), the ID Number would be visible whether it’s a PMI or SSN
DISCLAIMER:
This is a resource guide and all decisions on each dental office setup should remain the sole decision of the dentist/owner of the practice. Eaglesoft is a registered trademark of Patterson Dental Company. All other software or products mentioned are the property of their respective owners. Although Andre Shirdan was an employee of Patterson Dental, he is not associated with Eaglesoft or Patterson Dental Company or endorsed by Patterson or any other Company Mentioned in this blog.
