Is there a way within the software to mark when Pre-Authoizations have been returned from the insurance company and how much they have estimated to pay?
We created a codes that have the abilities to close a claim. We gave them the name "Primary Plan Approved" and "Secondary plan approved", Primary Plan Denied" Seceonday plan denied". I add these into the tx plan with the same group number as the tx on pre-D.
On the notation within the transaction I would also recommend placing the name of the plan in the check field and the group number., in the notes section I place the Claim number as stated by the ins company.
I scan the denial/approval, and file secondary if needed.
This does a few things:
1: informs TX plan Coordinator very quickly what action
has been made on tx group.
2.) the code closes a claim, therefore it will delete the claim if you need ( no lengthy pending ins reports) and will also provide opportunity to file the Secondary as well.
3.). You can them run a report that includes these codes in which you could contact pts. Perhaps a tx plan report in which you only select those codes that you created as "Approved".
As far as the need that would show how much was approved/ owed , you would have to
have pred on file and keep accurate Bluebooks and Allowance tables.
juriz or jeffrey.urkevich- can one of you assist?
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