Sunwave Billing Reports- Descriptions
- Oliver Nielsen (Unlicensed)
- Liane Melendez
UR Report | Static Report Run by All Active, Current Month, Last Month or specific dates. Shows insurance information such as Auth Code, Auth Dates, Number of Visits, Next Review, Auth Until, Auth Comments and more. Exportable |
UR Peer Review Report | Run by Created On/Resolved On. Shows status of Peer-to-Peer Reviews with comments and resolution. Exportable |
Auth Days Report | Run by Admission Date, Authorization State Date, Discharge Date or Next Review Date. Filters out time frame and claim status. Exportable |
Posting Report | Run by posting or deposit date. Pulls all payments posted within the selected time frame, and by whom. Detailed report of the claim/check/payment breakdown. Cannot be changed or altered. Exportable |
Claims Submission | Run by date of service or date of submission. Filters out time frame and claim status. Any data pulled from this screen is downloadable to excel. |
Manage Denials | Connects from posting status. Report that allows you to work on denials specifically. Any changes made in this report are only trackable via this report. Claim ID hyperlink will allow you to make changes to the denial status and make notes. |
Manage Paid to Patient | Connects from posting status. Report that allows you to work on P2P specifically. Any changes made in this report are only trackable via this report. Claim ID hyperlink will allow you to make changes to the denial status and make notes. |
Posting Report | Run by posting date or deposit date. Specific to realm you are in. |
Unbilled Report | *Please note this is intended for Inpatient Services. Run by Active, Admitted or Discharged patients. Based off Billing Facility. Will show how long a patient was active within the realm (Billable Days) and how many days were billed (ex: Patient is in Residential and was there for 15 days but only 12 were billed we have 3 days that should have been billed since Res is billed everyday). Exportable |
Unallocated Report | Run by Check Date/Deposit Date. Can sort by payment type. Will show any payment that was placed into the system but not allocated to completion. You can access the payments and complete allocation here as well. Specific to the realm you are in. Exportable |
Dynamic Reports/ Billing Report | Based on date of service or last submission. Pulls limited RCM information. Pulls from EMR CRM and RCM (no in-depth payment information). Pulls for all realms. Drag and drop fields can be brought to the top (column) or right side (rows). Updates as you pull. Exportable Savable |
Ad-Hoc Report | Based on either date of service, date of first submission, or date of last submission. Dimensions go in the columns and rows only. Measurements go with measurements. You can scroll through Dimensions/Measurements or use the search bar. Information is pulled from CRM EMR and RCM. This report connects to all realms. All fields drag and drop into the Columns Rows or Dimensions. When putting in an additional dimension/measurement after it has already been pulled, it needs to be reran with new data. Exportable Savable |
Payments Report | Based off of payment date or deposit date. Pulls from each individual line posted, including claim information. Pulls payment header information. Variance is the total from header of payment, not individual. Strict to the realm you are pulling in. Exportable Savable |
Aging Reports | Run by date of service or date of admission. Strict to realm you are in. Can pull Insurance or Patient Responsibility. Can sort by Insurance Financial Class or Patient Name. Pulls outstanding buckets by how long outstanding (0-30, 31-60, etc.). You can click on each number in the buckets to see what patients make up that number. Exportable |
Collections Report/Collector’s Desk | Run by date of submission or date of service. Ability to filter by Assigned User/Collector. Report on where the collections team can review claims cycle and create follow-ups. Insurance provider list will appear with the open balance and expected, can click on that payer name and all claims with a balance (within the selected filters) will open on the bottom detailing the claim data with the ability to add comments follow ups and labels. Follow ups are managed in the Task's tab where the collector can work from a list of follow ups assigned per date. Labels are visible. |
Collections Tracker Report | Search by Due Date/ Created Date/ DOS filter dates. Pulls follow up notes created by user and note details. Does not pull claim comments. Buildable report based on claim data, collection data, and collector assigned. |
Charges Report | Filter Date Required. Static report. Pulls claim data such as collection status and first submitted date. Exportable |
AR Report | Based on Date of Service only. Pulls claim information and full payment information. You can click on claim/remit numbers for visibility. Filter options are available, switch from basic to advance in the upper left-hand corner. You can add multiple requirements to filter information down, by claim, payment or payment header example: Looking at BCBS with $100.00 payments or status of Patient Responsibility you would add 3 requirements with this information. Strict to the realm you are pulling in. Exportable Savable |
KPI Report | Must be set up manually in Practice Set Up > Beds for KPI and Expenses for KPI. The information needs to have YYYYMM with the total for each and this is the one area with a save option in the upper right corner. Once entered the system will automatically pull when clicking the play/run option in the KPI report. Strict to the realm you are pulling in. |
Potential Revenue Report | Run by Service Dates. Must select the timeframe and always hit Search to pull. Provides the potential payments you should receive based off the percentages from previous collections (this is a potential not actual). Exportable Strict to the realm you are pulling in.
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Time to Collect | This report shows how many claims you are receiving a response within the specific schedules. In the first line, it shows the total number of claims that you received a payment from the insurance providers in 0-30 days, 31-60 days, and so on. The second line calculates the percentage of claims that are receiving payments for each one the the specified schedules. The third row shows the number of claims that were denied. The fourth row indicates the percentages for the prior line. The last 2 rows show the total number of claims (line 2 plus line 3) and their respective percentages. Specific to the realm you are in. |
Census Based Reports | Can’t be run for more than 30 days in an instance. |
With ICD10 and Authorization | Run by Service Dates. Must select the timeframe and always hit Search to pull. Exportable |
Billable Report | Run by Service Dates. Must select the timeframe and always hit Search to pull. Pulls services (forms) that are marked billable for both signed and unsigned notes. |
Revenue Recognition report | Run by Service Dates. Must select the timeframe and always hit Search to pull. Pulls the selected services on the census and charges associated for that service along with claim number and claim status. |
Level of Care Billing Census | Run by Service Dates. Must select the timeframe and always hit Search to pull. Pulls expected amount. Pulls claim status. |
Revenue Report | Run by service dates. Must select the timeframe and always hit search to pull. Pulls multiple Revenue data from the claim
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