Claims Dashboard Guide

Transcription

1 Claims Dashboard Guide July 2016 Independence Blue Cross offers products through its subsidiaries Independence Hospital Indemnity Plan, Keystone Health Plan East, and QCC Insurance Company, and with Highmark Blue Shield independent Page 1 of licensees 5 of the Blue Cross and Blue Shield Association.

2 The Claims Dashboard transaction offers you a comprehensive dashboard of Independence Blue Cross (Independence) pended and finalized claims through the NaviNet web portal. Providers are able to view their accounts receivable for claims in a pended or finalized status. Please note the following about this transaction: Claims Dashboard does not provide detail for individual claims. Providers should continue to use the Claim Status Inquiry transaction for specific claim detail. Data within Claims Dashboard is provided for general information purposes only. There is a lag time between finalized and pended claims data updates. Your designated NaviNet Security Officer is automatically granted access to Claims Dashboard and controls which end users associated with your NaviNet office are given access to the transaction. Using Claims Dashboard Access Claims Dashboard from the Independence Workflows menu by selecting Claim Inquiry and Maintenance and then Claims Dashboard. Next, choose a provider from the Billing Provider drop-down menu, and then select Submit. Note: If you receive the on-screen message Your health plan has not completed the Claims Dashboard configuration for your office, please call the ebusiness Hotline at for assistance. After selecting a Billing Provider, you will be on the Provider Summary screen, which shows an outline of pended and finalized claims data for the selected provider. Pended claims data is refreshed every business day, and finalized claims data is refreshed weekly and provides a summary from the prior week s activity. Page 2 of 5

3 Please note the following details about the numbered items in the image below: 1. The Home icon ( ) allows you to return to the Claims Dashboard selection screen. 2. By selecting the provider name, you can view supporting details about the claim. 3. Choose the Extract Pended Summary to Excel or Extract Finalized Summary to Excel if you would like to export the information to an Excel spreadsheet. If you select the provider name, you are presented with the Claims Dashboard detail screen, which offers three tab options at the top of the screen: 1. Claims Overview. By selecting the Claims Overview tab, you will see a more detailed summary of pended and finalized claims data. Select one of the three distinct date ranges for more detailed information about pended claims data: greater than 44 days (red) between 31 and 44 days (yellow) less than 31 days (green) Page 3 of 5

4 2. Pended Claims. By selecting the Pended Claims tab, you will see a more detailed summary of pended claims data. This screen offers you a variety of views: Pended Claims by Age Pended Financial Class Pended Financial Trend 3. Finalized Claims. By selecting the Finalized Claims tab, you will see the Finalized Category Summary screen (see image on next page), which provides a summary of finalized claims from the week prior, separated by category. Select any of the individual categories for more detailed information. The following additional views are also available: Adjustments Summary Finalized Financial Class Trend Payments Payments by Age Trend Page 4 of 5

5 If you have questions about the Claims Dashboard transaction, please call the ebusiness Hotline at NaviNet is a registered trademark of NaviNet, Inc., an independent company. Page 5 of 5