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Insurance reports
Eight reports about carriers, policies and claims. They read the Carrier catalog, each patient's Policies and the claims produced by the Insurance Manager, and they need the billing edition.
The three claim reports take the standard date range — which filters on the date the claim was created, not the date of service — and provider. The others are described with their own filters. See how every report works for the common controls.
Carrier Master
The carriers on file: ID, Company, Contact, Phone, Address, City, State, ZIP and Remark. Active carriers by default; tick Show Inactive to include retired ones.
This is the same report that appears as Carrier Master List in the Catalogs group.
Insurance Deductible
Every policy with its deductible, one row per patient per carrier, grouped by carrier:
| Column | Shows |
|---|---|
| Carrier | Company and ID |
| Patient, Chart, Provider | Who |
| Deductible | The annual deductible entered on the policy |
| Renew | The date the deductible resets |
| Remaining | How much of it is still to be met |
Only as good as the policy record: a policy with no deductible entered shows blank. Provider filter only — there is no date range.
Patient by Carrier
Every patient covered by each carrier, with where their account stands:
| Column | Shows |
|---|---|
| Carrier | Company and ID |
| Patient, Chart, Provider | Who |
| Status, Type | Patient status and account type |
| Patient Balance, Insurance Balance | What is owed on the account |
Provider filter only. Sort by Insurance Balance to see which carrier is holding the most of your money.
Secondary Insurance
Patients who have a secondary policy — a second carrier in the policy order — with the carrier's details and the insured person:
| Column | Shows |
|---|---|
| Carrier Id, Company, Contact, Phone, Payor Id | The secondary carrier |
| Chart, Insured Person, Sex, DOB, Insured Person Phone | The patient |
Secondary claims are the ones most often forgotten. This is the list of accounts where a secondary claim may be due after the primary pays.
Patient by Insurance
Patients admitted in the date range, listed under each carrier they are covered by, with the same carrier and insured-person columns as Secondary Insurance. It is the new-patient intake seen from the carrier's side: which carriers your new patients arrive with.
Insurance Claim Review
Claims created in the range summarised by carrier:
| Column | Shows |
|---|---|
| Id, Company | The carrier |
| Bill | Total billed |
| Paid | Insurance payments posted against those claims |
| Copay | Co-pay amounts |
| Writeoff | Written off |
| Transfer | Transferred to the patient |
| Due | Bill less co-pay, paid, transfer and write-off |
Click a carrier to open the details — the same columns per claim, with chart, patient and dates of service — which shows which claims make up that carrier's outstanding figure.
Insurance Claim Outstanding
Claims created in the range that still have a balance due, one row per claim:
| Column | Shows |
|---|---|
| Chart, Contact | The patient, and the carrier's contact |
| Age | Days since the claim was created |
| Dos From, Dos Thru | The dates of service on the claim |
| Billed, Paid, WriteOff, Refused, Due | The claim's money |
Sort by Age descending and you have the follow-up list: the oldest unpaid claims at the top. A claim past 30 days without a payment or a rejection on file is one to chase.
Line Item Claim Auditor
A check of each claim's line items against the ledger, listing only claims where something does not add up:
| Column | Shows |
|---|---|
| Patient, Claim ID, DOS | The claim |
| Issue(s) | What was found |
The issues it reports, and what each usually means:
| Issue | Usually means |
|---|---|
| Missing Services | The claim has no service lines behind it |
| Missing Credits | A line was paid on the claim but no matching payment is on the ledger |
| Negative Balances | A line has been credited more than it was billed |
| Incorrect Payments | A payment on a line does not match what was posted |
| Unassociated Transactions | Ledger entries for the claim's dates that are not tied to any line |
| Negative Balance Due | The claim as a whole shows more credited than billed |
Most of these come from posting an insurance payment through Transactions instead of Post Insurance, so the money never attached to the claim. Fix them there.