14.33 PPS Claims Sent but Not Paid


How to Run the Report

From the Main Menu in Barnestorm Office click on Billing > Reports > 14.33 PPS Claims Sent But Not Paid; Or from the Billing Screen, select Reports>14.33 PPS Claims Sent But Not Paid.  

(NOTE:  If "Reason For Not Receiving Full Payment" (on the Edit PPS Episodes Screen) is marked as "DENIED" or "NO VISITS," those episodes will not appear on this report.)

1. Program(s) / Payer(s) = Filter report by entering program or payer number(s). Or leave blank to select all.

2. You have the option to choose RAP claims, EOE Claims; Or you can check both boxes to include unpaid RAPs and unpaid EOEs on the report.

3. Medicare Only / Non-Medicare Only / Both = Select which payer type you want to select; or include both types by selecting Both.

4. RAP Days = Enter the number of days of how long ago the RAP was created.  The report will pull RAP claims that are at least this age and older.

5. EOE Days = Enter the number of days of how long ago the EOE was created.  The report will pull EOE claims that are at least this age and older.

6. Exclude Claims Created > 15 months ago - By checking this box, all claims created greater than 15 months ago will be excluded from the report.

7. Only Claims Created > 15 months ago - By checking this box, ONLY claims created greater than 15 months ago will be included in the report.

***NOA(s) are excluded from this report.

Print Options:

a. Print by Patient Name/From Date

b. Print By Date Claim Created

c. Landscape (located at the top beside the print button)

d. Export to Excel (located at the top beside the print button)

How to Read the Report

1.  Chart# = Patient Chart number.

2.  Patient's Name = Patient name.

3.  Pg/Pyr = Program/Payer assigned to episode.

4.  Tm = Team number assigned to patient.

5. FromDate = The from date of the episode.

6.  ThruDate = The thru date of the episode.

7.  HIPPS = The HIPPS code that is on the RAP claim.

8.  $Amount = HIPPS amount from the RAP claim.

9.  A/R Balance - Any outstanding balance on account.

10. RAP Date = Date when the RAP was created.  If date is blank then that row is for the EOE claim.

11. EoE Date = Date when the EOE was created.  If date is blank then that row is for the RAP claim.

12. HIC Number = The patient’s Medicare number or insurance ID.