Tracking of missing data and follow-up at the guarantor and claim level is a basic feature of PiMS Billing and Collections. Each facility can define the data it needs to track for missing information and worklisting criteria. The system produces automated worklists that provide appropriate information to allow the biller to make the proper follow-up decisions.

Patient Tracking

The tracking of data elements which are necessary for billing as well as administrative items, such as signatures or incomplete forms can be started at the registration point. It is necessary to have an account created to begin the tracking as it then meets the tracking cycle criteria. Insurance information (policy number, group number, authorization codes) and account information (patient’s SSN, address, final diagnosis, discharge MD, etc.) can both be tracked for accuracy and completion.

Patient Tracking creates worklist and consists of accounts that have administrative tasks, missing information or information that requires a review. For each worklist entry, a list of data elements or administrative items are listed on a worklist.

PiMS allows you to determine which tracked elements hold the claim. As each insurance has its own set of tracked elements, it is possible to hold one claim for one insurance but not another insurance. The account will be billed but PiMS will only hold the claims for insurance with tracked elements. When all tracked elements for the insurance are satisfied, PiMS will automatically release the claim and reformatted to include any changed information.