Task Manager-Tasks 101

Introduction Task Manager is an integrated part of EDIinsight that allows a user to create tasks. These task will

enhance your use of the application and ensure that important EDI transactions are followed up on.

Through Task Manager you can create tasks to follow-up on rejected or invalid claims, timely filing,

denied claims, denied ERA transactions, and open support issues.

Through using Task Manager you will see a reduction in AR days, easy identification of rejected claims,

and better ERA follow-up. This document will walk you through creating task that can help you assist

your customers. This document will provide with the required filter to see that type of claims.

Additional can be added to the task for further customization.

Tasks to create for every customer

Separate tasks by staff responsibility

Vendor level tasks that help support your customers

Tasks to create for every customer

Invalid and Rejected Claims Claims are INVALID because they have been rejected by edits in Practice Insight systems. REJECTED

claims have been rejected by edits in the Insurance Payer or other Trading Partner system. Claims that

are INVALID and REJECTED have not made it into the Insurance Payers Adjudication system and have

errors that need to be fixed. This task will help you easily identify INVALID or REJECTED claims.

Required Fields:

Status: Select INVALID and REJECTED

Denied Claims DENIED claims are claims that have been processed by the insurance companies but have been denied

on an EOB. DENIED claims may have received no payment or an underpayment. This task will help you

find DENIED claims.

Required Fields:

Status: DENIED

Valid Claims If a claim is VALID it means that it has passed all the edits at Practice Insight but has been made READY

so that it will be sent to the payer. This task will help you ensure that all claims that can be sent to the

payer are READY.

Required Fields:

Status: VALID

Claims Over X Days old This task will allow you to find claims that are over a certain number of days old and will help prevent

timely filing issues. The most important thing to identify is the last response report that you will receive

from the payer and the status that it will update your claim and typically how may days after the claim is

submitted this is received. This can be done by looking at the “Status Message Section” for the selected

claim. Because this varies payer by payer you will want to setup a separate task for each insurance

payer.

Required fields:

Status: ACCEPTED, ACK, ACK-997, ACK-CH, ACK-PYR, or ACK-TP.

Payer Type or Payers: Select a specific payer from your Payer list. Clicking on the Filter List

button will make it easier to find a specific payer. Make sure that you use the Include/ Exclude

List feature.

CLAIM AGE in DAYS: Select the date range for the claims.

Tasks by division of labor in office

Clinical Claim Scrubbing Errors The filters available in Task Manager allow you to view claims that are INVALID for Clinical Claim

Scrubbing. This allows you to assign scrubbing errors to the coder in your office to work.

Required fields:

Status: Only INVALID

Scrubbing Errors: Only

Additionally you can use the Scrub Type List to separate scrubbing errors by the type of error.

Patient Last Name Range The Patient Range field allows you to separate claims in a task by the last name of the patient. In the

Patient Range field you can include a multiple letter range in the patient name. Users can now search by

a-b, aa-br, or aaa-brz. For example if you were looking for Jones – Madison you could use a search of

jon-mad.

Patient Name: Enter the range for the patient’s last name. Range can be in the following format: a-b, aa-br, or aaa-brz.

By Rendering Provider or Billing Provider Rendering Provider and Billing Provider allows you to view claims by the billing or rendering provider

submitted on the claim.

Rendering MD(s): Select the Rendering provider from the provider list. You can use the Include/Exclude

option to determine what providers you want include in the tasks.

By Insurance Payer or Payer Type Payer Type or Payers: Select a specific payer from your Payer list. Clicking on the Filter List button will

make it easier to find a specific payer. Make sure that you use the Include/ Exclude List feature.

Vendor Level Tasks

Invalid and Rejected Claims Claims are INVALID because they have been rejected by edits in Practice Insight systems. REJECTED

claims have been rejected by edits in the Insurance Payer or other Trading Partner system. Claims that

are INVALID and REJECTED have not made it into the Insurance Payers Adjudication system and have

errors that need to be fixed. This task will help you easily identify INVALID or REJECTED claims.

Required Fields:

Status: Select INVALID and REJECTED

Valid Claims If a claim is VALID it means that it has passed all the edits at Practice Insight but has been made READY

so that it will be sent to the payer. This task will help you ensure that all claims that can be sent to the

payer are READY.

Required Fields:

Status: VALID