Reports

The Report section of the application provides you with access to our Central Business Intelligence (CBI) tool which includes the report viewer and report builder, as well as access to the Clearinghouse Reports. These enhanced reporting capabilities will allow you to visualize and analyze your data using business intelligence that is centric to your business.

The following help pages are supported by the current version of CollaborateMD. Please follow the curriculum outline to receive the proper training associated with this section.

Report Viewer

Report Builder

Clearinghouse Reports


Clearinghouse Reports consist of Acknowledgement, Exclusion and Payer Generated Reports. These reports provide details on any claims that have been accepted or rejected by the Clearinghouse or the Payer. See Clearinghouse Report Description for a description of each report. We recommend that these reports be viewed on a daily basis in order to stay up to date with the status of your claims. Not reviewing these reports  on a daily or weekly basis can result in rejected claims not being resubmitted for processing. 

Search for Clearinghouse Reports

Follow the instructions below to search for Clearinghouse Reports:

  1. Go to the Reports section.
  2. Click on the Clearinghouse Reports tab.
  3. Enter your search details based on the information you're looking for. See the legend below.
  4. When your search filters are entered, click on the Search button.
  5. The reports that meet your search criteria will be displayed. Select the appropriate tab to view the associated reports.
  6. Double click on the report you would like to open.

  1. Search: Click this button to search for reports.
  2. Saved search filters: Click on the Magnifying Glass to search for saved filters. Click on the Save icon to save your filters for future use.
  3. Reset Filters: Click this button to reset your search filters.
  4. Search Criteria:
    • Retrieve Listing of Reports Not Viewed: Select this option to only view reports that have not been viewed.
    • Retrieve Listing of All Reports: Select this option to retrieve a listing of all reports.
  5. Use date range to find reportsWhen selected, the dates in the To/From filters are used to limit the reports returned based on the date the report was received from the Clearinghouse. Otherwise, the To/From dates are ignored and all reports are returned.
  6. Range: Click on the drop down menu to select a range date.
  7. From/To: Use this field to manually enter a date range.
  8. Containing Content: Use this field to enter key words related to what you're searching for. Example: Patient Name, TCN#, Rejection Message, CPID etc.

Clearinghouse Descriptions

Acknowledgement Report


The Acknowledgment Report contains a list of submitted claims, along with indicators to show how each claim will be distributed, whether the claim failed any exclusions which prevent it from being forwarded to the payer and how many additional claims (referred to as supplemental claims) will be billed submitted by the Clearinghouse for in the event they exceed six line items for professional claims or 23 line items for institutional claims. The Summary Totals By CPID portion of this report will show the number of claims and claim amount for each CPID/State that was submitted. Once reviewed, this report becomes a historical record of claims processed.

Exclusion Report


The Exclusion Report contains claims that have been excluded by the Clearinghouse based on edits they receive from the payer. This report includes claim details followed by a brief explanation of why the claim was excluded. This report is intended to be a workable report for those who are assigned to 'cleaning up' submitted claims so they can be forwarded to the payer. All excluded claims for a particular payer will be grouped together.

The format of the Exclusion Report is modeled after the Acknowledgment Report so you can quickly identify information on either report. The totals from the Exclusion Report will match the totals of the Acknowledgment Report with the same processing date. While enough information is provided on the report for correcting most exclusions, there may be times when you will need assistance verifying why a claim was excluded, if so please Contact a Client Services Representative.

The Exclusion Report is vital in getting the listed claims paid. Without it, these claims would not get corrected and resubmitted to the Clearinghouse, and therefore, will never reach the payer for processing.

Payer Generated Report


The Payer Generated Report contains information about claims that were accepted and rejected by the payer's front end. The payer’s front end will either accept the claim and enter it in the payer’s adjudication system or deny the claim and submit it back to the Clearinghouse. Please be aware that not all payers participate in submitting this type of report.
  • SR: Filenames that begin with SR are the Clearinghouse's version of the Payer Generated Report. Information from these reports are viewable in Claim Tracking. 
  • SB: Filenames that begin with SB are Normalized Payer Batch Reports. These reports show only batch information from the payer reports. Information from these reports are NOT always viewable in Claim Tracking. 
  • SE: Filenames that begin with SE are Normalized Payer Error Reports. These reports show only error information from SR reports. Information from these reports are viewable in Claim Tracking.

Note:
Claim Tracking will show you everything listed in the Acknowledgement and Exclusion Reports. Since not all responses from the Payer Generated Report are parsed in Claim Tracking you will have to also review the Payer Generated Report. Therefore on a daily basis you should check both Claim Tracking and the Clearinghouse Reports to track the life cycle of your claims.