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Provider Payment Profile Report Update - June 2020

Provider Payment Profile Report, EIBilling v2.71, June 2020.

An update was recently made on the Provider Profile Report which brings the grid into balance, and updates the values displayed, including a new row titled ‘Closed’.

Providers may access this report directly via the ‘Provider Payment Profile’ link on their dashboard; or navigate through the menus via:  Reports > Financial > Provider Payment Profile. 

Municipalities have the menu navigation available, too.

A total in the Pending column will be populated on the Closed row. This total represents the dollar amount of claims that are in a Closed status but with an outstanding balance. The most common reason for claims in this section are claims that are not payable due to timely filing guidelines.

Regarding timely filing, consider an example where a claim with a service date of January 1, 2020 is submitted on May 1, 2020, exceeding the 90-day timeline. If the claim is not fully paid by Insurance or Medicaid, any outstanding balance will not be paid through Escrow. As a result, the claim will move to a Closed status with a remaining balance on the claim.

A user can obtain a detail list of these claims via the Claim Research Report and clicking the ‘Claims Greater Than 90 Days’ box; also note the guideline was effective February 11, 2019, so any service date prior to then will not be impacted by the guideline.

This report contains a ‘Late Claim Adjustment Column’ which displays amounts of any claims not paid as a result of the Timely Filing guideline; and may be exported to Excel.

Additional claims not on the Claim Research include claims that were either overpaid and/or are awaiting a response from Commercial insurance or Medicaid.

For additional questions, please contact the Customer Service Center at 1-866-315-3747 Monday - Friday, from 7:00 AM to 7:00 PM, ET.

Article ID: 439, Created On: 6/4/2020, Modified: 6/4/2020

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