Predetermination - Tracking Report

The Predetermination - Tracking report displays the status for each predetermination that has been sent to payers in the last 180 days. Ascend Academic displays the status as is received from the payer clearinghouse. Use this report to follow up with or resubmit predeterminations to payers and to follow up with patients regarding their predeterminations.

Also, because the report is grouped by insurance carrier, it may help you identify patterns with certain payers. For example, if a specific carrier consistently takes an extended period of time to accept predeterminations, you can follow up to find out why this is happening.

To generate the report

1. On the Power Reporting page, select Clinical to generate a list of clinical reports.

   

   Tip: Instead of selecting Clinical, you can enter Predetermination - Tracking in the Search field on the left-corner of the page to locate the report's icon.

2. ClickTap the Predetermination - Tracking icon.

   

   The report displays.

   

   The report displays the following information per predetermination:

   • PreD Carrier - The name of the insurance carrier that the predetermination was sent to.

   • PreD Coverage Type - Whether the predetermination was submitted for primary or secondary insurance coverage. This field reflects only the most recent submission.

   • PreD Status - The status of the predetermination. The following statuses are possible:

     Accepted Additional Information Requested Paid Payment Received Pending Printed Queued Received

     Rejected Resubmitted Sent Settled Unprocessable Claim Unsent Voided Zero Payment

   • Patient - The name of the patient on the predetermination.

   • PreD ID - The unique ID of the predetermination.

   • PreD Sent Date - The date when the predetermination was sent to the payer.

   • PreD Status Date - The date when the current status of the predetermination was received.

   • Scheduled/Unscheduled - If the patient has an appointment scheduled for the procedures on the predetermination, displays as Scheduled; otherwise, displays as Unscheduled.

   • Proc Code - The procedure codes on the predetermination. A code appears once regardless of how many instances of that code are on the predetermination.

   • Amount - For each procedure code on the predetermination, the amount that was submitted to the payer. If there are multiple instances of that code on the predetermination, the amount is the sum of all the instances of that code on the predetermination.

     Tip: To see how many instances of each procedure code contribute to the Amount, you can add the Procedure Count data field to the report layout.

3. (Optional) Clicktap the Data as of button to view the time when the next sync is expected to occur.

   

   Note: Data from your database automatically syncs with the reporting system and displays the time of the last sync on the button. Data entered after the last sync will not be available on the report until the next sync.

   The Sync Info window displays.

   

4. Using the analysis report builder tools, add data fields to the layout and set the filters as necessary.

5. (Optional) Save the report as a template.

   1. ClickTap Save.

      

      The Save Report window displays.

      

   2. Select the following fields as necessary:

      • Report Name - Enter the name of the report.

      • Save To My Reports - Select the radio button to have the template only available to you.

      • Save To Organization Reports - Select the radio button to have the template available to all users.

   3. ClickTap OK.

6. (Optional) Export the report as a PDF, Excel, or CSV file.

   1. ClickTap the icon.

      

   2. Position the pointer overTap and hold Export and select the desired file format.

      

      A window with options to set the file's format displays.

   3. Set the file's format on the displayed window, such as the export options, page format, and page orientation.

   4. ClickTap Done to only apply the settings to the report or clicktap Export to apply the settings to the report and export it.