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Predetermination Report - Outstanding Predetermination

The Outstanding Predetermination Report displays all outstanding predeterminations as specified by the report filters.

Outstanding Predetermination - Filters
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  • Providers: Filters the report by the patient provider associated to the predetermination.
  • Offices: Filters the report by the office provider associated to the predetermination.
  • Insurances: Filters the report by the Insurance associated to the predetermination.
  • Date Updated Start/End Date: Filters the report by the date range in which the predetermination was updated.
  • Claims to Include: This menu filters the report by Paper, Electronic, or Both types of claims.
  • Plan Type: Filters the report by Plan Type.
  • Threshold Claim Type: This menu filters the report by Warning Claims, Past Timely Filing, Warning and Past Timely Filing, or All Types of Threshold Claim Types.
Outstanding Predetermination - Results
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  • Patient #: The patient number of the patient with the outstanding predetermination
  • Patient Last, First: The first and last name of the patient with the outstanding predetermination
  • Birthday: The birthday of the patient with the outstanding predetermination
  • Subscriber: The Subscriber Number of the outstanding predetermination
  • Pr/Of: The provider and office of the outstanding predetermination
  • Insurance Company: The Insurance Company of the patient with the outstanding predetermination
  • Plan Type: The plan type of the patient with the outstanding predetermination 
  • Total Amount: The total amount of the outstanding predetermination
  • Date Updated: The most recent date which the outstanding predetermination was updated
  • First Procedure Date: The first procedure date associated to the outstanding predetermination
  • Days Past Claim Created: The number of days that have passed since the claim was first created
  • Days Until Overdue: The number of days until the claim is overdue
  • Type: The type of claim (paper or eClaim)
  • Timely Filing Limit: The timely filing limit associated to the claim based on the Insurance Reference.
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