The line item Insurance Aging Analysis report is a charge-based report and used to show aging by responsible payer. This report is different from other aging reports because all other aging reports age by primary payer.
This report shows the responsible payer in the COB (Coordination Of Benefits) column. The responsible payer is represented by one of the following codes:
| Field | Description |
|---|
| P | Patient Pay |
|---|
| 1 | Primary Payer |
|---|
| 2 | Secondary Payer |
|---|
| 3 | Tertiary Payer |
|---|
The responsible payer is determined by the following rules:
- The primary payer displays when the primary insurance bucket has either a positive or negative balance.
- The secondary payer displays when the primary insurance bucket is zero and the secondary insurance bucket has either a positive or negative balance.
- The tertiary payer displays when the primary and secondary insurance buckets are zero and the tertiary insurance bucket has either a positive or negative balance.
- The patient pay displays when the primary, secondary, and tertiary buckets are zero.
You can filter the aging analysis report by Process Date, so that you can retrieve data from any point in time.
Note: : If you run the insurance aging analysis report by line item for balance purposes then you must select all the charge status check boxes from Charge Status. If you run the report for AR (Account Receivable) purposes then you can select the Billed, Rebill, and Unbilled check boxes from Charge Status.
The report has "drill-down" functionality that enables you to double-click on a record to access the Account Profile window directly from the report.
To access the report in NextGen® Enterprise PM, select the Reports menu and select Accounts Receivable, then select Collections, and then select Insurance Aging Analysis.
From the Report Filter window, select Info to view the following information about the report:
Logic:
- This report is based on the charges within the filtered date range and will display one line for each charge, along with its associated transactions.
- The COB column refers to Primary (1), Secondary (2), Tertiary (3) and Patient (P).
- The charges and associated information display against the current responsible Payer/Financial class with the highest ranking COB. In other words, if the patient has two insurances, Medicare and BCBS and Medicare has already paid their portion the balance would report against the BCBS Payer/Financial class (COB column would be "2" for secondary). Once BCBS pays their portion if there is a patient balance, the report would display the line item as patient responsibility (COB column would be "P" for patient).
Filtering Info:
- Unapplied credits:
- Unless they are specifically excluded, account unapplied credits will always show regardless of the filters selected.
- Some of the filters are applied against Encounter level unapplied credits (e. g. Location, Patient status). Therefore, when using this report to evaluate bad debt balances, unapplied credits should be excluded in Filter 1.
Common Uses:
- Evaluate and work accounts receivable based on the current responsible payer.
Balances to the Following Reports:
The total outstanding A/R from this report should balance to the total outstanding A/R from:
The Aging Analysis reports Recreating Historical Balance Information:
- The historical financial class/payer information is not retained in this report. Once the balance reaches a history status, it will report as “self-pay/patient pay”.
- To recreate the A/R balance for a prior process date or to balance to the following reports, all charge statuses must be included in Filter1:
- Monthly Changes in A/R
- Receivable Analysis
