Once a claim is created for a patient, a user can view it from the "Billing and Claims" worklist. This article will cover how to navigate the "Billing and Claims" worklist.

Billing and Claims Worklist:

From the ThoroughCare Dashboard, locate the Billing & Claims section towards the bottom of the page. Click the "Billing and Claims" title to navigate to the worklist.

Worklist Filters:

Once the Billing and Claims Page loads, navigate to the "Filters" button to view the Worklist Filters available. Notice the different filters that are offered by ThoroughCare. A user can filter claims by:

  • Status

  • Product

  • Date from

  • Date to

  • Provider

  • Care Manager

  • Department

  • Flags

Click the drop down arrow for any of these filters to view the possible filtering options.

Highlighted below is the "Mark All Submitted" button. To learn how properly use the mark all as submitted feature click here.

To view more records per page click the "Show" drop-down and select the number of claims that should be shown on each billing claims worklist page. Your options are 10, 25, 50, and 100.

If the billing worklist is displaying too many columns, users have the ability to hide columns by clicking the "Column Visibility" drop down. Click a columns name to hide a target column from displaying on the billing and claims worklist.

Note: The displayed columns are selected in blue whereas the hidden columns remain white.

Creating a Billing and Claims Worklist Report:

First, the user must select the records that are to be included in the report. If all records under the chosen filters are to be included click the small check box to the left of the "Flags" column, as shown below.

Once the check box is clicked, notice that all records will now be highlighted in yellow this lets the user know that they are selected.

If the user only needs to select a specific group of claims to include in the report, simply select the individual claims to be included by clicking the checkbox to the left of the target claims.

Note: As claims are selected they will be highlighted in yellow.

Once all target claims are selected click either the "CSV" or "PDF" button to create the desired report.

Once the report is generated ThoroughCare will notify the user in the upper right hand corner that the document has been created. Click the green "Your report is ready" message bubble to download the report to your chrome browser.

Individual Claims:

If a user wishes to mark an individual claim as submitted, they only need to click the "Mark as Submitted" button located to the far right of the claim. This will mark that individual claim as submitted.

Note: Submitting a claim is non-reversible if your ThoroughCare site is currently integrated with an EHR such as Athena, so be careful when submitting a claims.

Putting a Claim on Hold:

If a user wishes to put a claim on hold they can do so by clicking the "Put on Hold" button to the right of the claim just under the "Mark as Submitted" button.

Note: This will move the claim from the "Ready to Bill" worklist to the "On Hold" worklist.

Changing a Care Manager or Physician Listed on a Claim:

If the Physician or Care Manager on the claim is incorrect and needs to be updated, a user can do this by clicking the name of the CM or Physician currently listed.

A "Set Claim Care Manager" pop-up will appear, click the drop-down list to select the correct CM or physician to be added to the claim.

Once the correct user is chosen, click the "Save" button at the bottom of the pop-up. This will update the existing claim with the correct CM or Physician.

Updating Conditions Listed on Claim:

Users have the ability to update the conditions listed on individual claims by clicking the conditions listed on the target claim.

By clicking the claims, a user will bring up the current list of ICD10 codes attached to the claim. Add new conditions by clicking "Add Condition" at the bottom of the pop-up.

In order to travel to a patient's view page, a user would have to select a patient's Name or EHR ID, as shown below.

For more information on using the billing and claims worklist, not discussed in this article, chat with a ThoroughCare professional by clicking the blue chat bubble in the bottom right hand corner of every ThoroughCare screen!

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