Overview of Patient Accounting Workqueue Recommendations - Patient Accounting Help Pages (2024)

Work QueueQueue TypeFunctional AreaStaff Role AssignmentQueue Review FrequencyQueue Item Resolution Frequency

Newborn Medicaid Billing(Separate Medicaid Number)

Newborn Medicaid Billing(Same Claim)

Work ItemInsurance BillingInsurance BillerDaily

Weekly

Note

The resolution frequency of this work queue is dependent on the associatedMedicaid policy.

Appeal SubmittedWork ItemDenials & VarianceInsurance Biller

Daily

Weekly

Note

The resolution frequency of this work queue is dependent on payer response timelines.

Contract ReviewWork ItemDenials & VarianceContract Management StaffWeeklyMonthlyContract Variance PostedWork ItemDenials & VarianceInsurance BillerWeeklyMonthlyActive Duty MilitaryWork ItemSelf Pay BillingSelf Pay BillerMonthlyMonthlyNon-Billable Encounter with ChargesWork ItemRevenue IntegrityRevenue Integrity StaffDailyDailyCharge ModificationWork ItemRevenue Integrity

Coder

Clinical Staff

DailyDailyCharge Service Date out of BoundsWork ItemAccount ManagementRevenue Integrity StaffDailyDailyDepartment ReviewWork ItemVariesVariesDaily

Weekly

Note

The resolution frequency of this work queue is dependent on the associated department assignment.

Ambulatory Practice ReviewWork ItemAccount Management

Clinical Manager

Practice Administrator

DailyDailyWork ItemAccount ManagementClinic CoderDailyDailyPhysician Note ReviewWork ItemRevenue IntegrityClinic CoderDaily

Weekly

Note

The resolution frequency of this work queue is dependent on the associated department assignment.

Professional Coding - AnesthesiaWork ItemProfessional CodingClinic CoderDailyDailyProfessional Coding - Invasive and Noninvasive CardiologyWork ItemProfessional CodingClinic CoderDailyDailyProfessional Coding - SurgeryWork ItemProfessional CodingClinic CoderDailyDailyProfessional Coding - Women's HealthWork ItemProfessional CodingClinic CoderDailyDailyPending MedicaidWork ItemAccount ManagementFinancial CounselorDaily

Weekly

Note

The resolution frequency of this work queue is dependent on Medicaid response times.

Perioperative Implant BillingWork ItemRevenue Integrity

Biller

Perioperative Services Department

DailyDailyRecurring Health Plan ChangeWork ItemAccount ManagementInsurance BillerDailyDailyRegistration Review RequiredWork ItemAccount ManagementRegistrarDailyDailyResearch Patient Episode of Care ReviewWork ItemNon-Patient AR

Research Coordinator

Revenue Integrity Staff

See Also
Using CPDI Work Queue Monitor - Oracle Health Document Imaging Help PagesConfiguring a Work Queue in CPDI Work Queue Manager - Oracle Health Document Imaging Help PagesManage Unknown Queue in Work Queue Monitor (WQM)

DailyDailyPrepayment Review - Women's HealthWork ItemSelf Pay BillingSelf Pay BillerDailyWeeklyWH Medicaid BillingWork ItemInsurance BillingInsurance BillerDailyDailyMonthly Hard CloseWork ItemRevenue IntegrityBusiness Office ManagerMonthly

Weekly

Note

The resolution frequency of this work queue is dependent on the local hard close date.

Timely FilingWork ItemInsurance BillingInsurance BillerDaily

Weekly

Note

The resolution frequency of this work queue is dependent on the timely filling notification date.

Bankruptcy Pending ReviewWork ItemSelf Pay BillingSelf Pay BillerWeeklyWeeklyPending Financial AssistanceWork ItemSelf Pay Billing

Financial Counselor

Business Office Supervisor or Manager

Daily

Monthly

Note

The resolution frequency of this work queue is dependent on patient response times.

Self Pay After MedicaidWork ItemSelf Pay BillingSelf Pay BillerDailyWeeklyManager Refund ResolutionWork ItemTransaction PostingBusiness Office ManagerDailyDailyMedically Related - Combine EncountersWork ItemInsurance BillingInsurance BillerDailyDailyMedically Related AssessmentWork ItemInsurance BillingCoderDailyWeeklyNot Medically Related - Move ChargesWork ItemInsurance BillingInsurance BillerDailyDailySupervisor Refund ResolutionWork ItemTransaction PostingBusiness Office SupervisorDailyDailyHIM Interim Dx RequestWork ItemRevenue IntegrityCoderDailyDailyHIM Medical Records ReqWork ItemRevenue Integrity

Medical Records Department

ROI Department

DailyDailyHIM: Coding - Holding for Dept/CathLabWork ItemRevenue IntegrityClinical Staff (Cath Lab)DailyDailyHIM: Coding - Holding for Dept/EDWork ItemRevenue IntegrityClinical Staff (ED)DailyDailyHIM: Coding - Holding for Dept/LabWork ItemRevenue IntegrityClinical Staff (Lab)DailyDailyHIM: Coding - Holding for Dept/RadiologyWork ItemRevenue IntegrityClinical Staff (Radiology)DailyDailyHIM: Coding - Holding for Dept/Rev IntegrityWork ItemRevenue IntegrityRevenue Integrity StaffDailyDailyHIM: Coding - Holding for Dept/SurgeryWork ItemRevenue IntegrityClinical Staff (Surgery)DailyDailyRefer to HIM: Multiple Primary Carve OutWork ItemRevenue IntegrityCoderDailyDailyRefer to HIM: Recurring Health Plan ChangeWork ItemRevenue IntegrityCoderDailyDailyTechnical Denial - Additional Info NeededWork ItemDenials & VarianceInsurance Follow-up RepresentativeDaily

Weekly

Note

The resolution frequency of this work queue varies.

Technical Denial - BenefitsWork ItemDenials & VarianceInsurance Follow-up RepresentativeDaily

Weekly

Note

The resolution frequency of this work queue varies.

Technical Denial - Billing Submission ErrorsWork ItemDenials & Variance

Insurance Follow-up Representative

Self-Pay Biller

Daily

Weekly

Note

The resolution frequency of this work queue varies.

Technical Denial - Case ManagementWork ItemDenials & Variance

Insurance Follow- up Representative

Case Manager

Daily

Weekly

Note

The resolution frequency of this work queue varies.

Technical Denial - CodingWork ItemDenials & Variance

Insurance Follow-up Representative

Coder

Daily

Weekly

Note

The resolution frequency of this work queue varies.

Technical Denial - Medical NecessityWork ItemDenials & VarianceInsurance Follow-up RepresentativeDaily

Weekly

Note

The resolution frequency of this work queue varies.

Technical Denial - OtherWork ItemDenials & VarianceInsurance Follow-up RepresentativeDaily

Weekly

Note

The resolution frequency of this work queue varies.

Technical Denial - Provider/Physician Follow-upWork ItemDenials & VarianceInsurance Follow-up RepresentativeDaily

Weekly

Note

The resolution frequency of this work queue varies.

Technical Denial - Registration/EligibilityWork ItemDenials & Variance

Insurance Follow- up Representative

Registrar

Daily

Weekly

Note

The resolution frequency of this work queue varies.

Technical Denial - Reimbursem*ntWork ItemDenials & VarianceInsurance Follow-up RepresentativeDaily

Weekly

Note

The resolution frequency of this work queue varies.

Technical Denial Review RequiredWork ItemDenials & VarianceVariesDaily

Weekly

Note

The resolution frequency of this work queue varies.

OCE Lab Edits: 80048

Work ItemRevenue IntegrityLab DepartmentDailyDailyOCE Lab Edits: 80051Work ItemRevenue IntegrityLab DepartmentDailyDailyOCE Lab Edits: 80053Work ItemRevenue IntegrityLab DepartmentDailyDailyOCE Lab Edits: 80069Work ItemRevenue IntegrityLab DepartmentDailyDailyOCE Lab Edits:80076Work ItemRevenue IntegrityLab DepartmentDailyDailyOCE Lab Edits: 81003Work ItemRevenue IntegrityLab DepartmentDailyDailyOCE Lab Edits: 82575Work ItemRevenue IntegrityLab DepartmentDailyDailyOCE Lab Edits: 82945Work ItemRevenue IntegrityLab DepartmentDailyDailyOCE Lab Edits: 84160Work ItemRevenue IntegrityLab DepartmentDailyDailyOCE Lab Edits: 85025Work ItemRevenue IntegrityLab DepartmentDailyDailyOCE Lab Edits: 86141Work ItemRevenue IntegrityLab DepartmentDailyDailyCase Management Adjustment OrderWork ItemRevenue IntegrityCase ManagerDailyDailyCase Management Review RequiredWork ItemInsurance BillingCase ManagerDailyDailyCase Management Status ReviewWork ItemInsurance BillingCase ManagerWeeklyWeeklyPossible Two MidnightWork ItemInsurance BillingCase ManagerDailyDailyIME Pending EditsWork ItemInsurance BillingInsurance BillerDailyDaily835 File FailureWork ItemTransaction PostingIT DepartmentDailyDailyTransaction Batch DeniedWork ItemTransaction Posting

Insurance Biller

Self-Pay Biller

DailyDailyEmployee Payroll DeductionWork ItemSelf-Pay BillingSelf-Pay BillerDailyDailyEncounters Without ChargesWork ItemRevenue IntegrityBack Office StaffDailyWeeklyFinancial Assistance AdjustmentWork ItemSelf-Pay BillingFinancial CounselorDailyDailyFinancial Assistance ReviewWork ItemSelf-Pay Billing
Daily

Daily

Note

This frequency applies only to outpatient encounters.

Patient DeceasedWork ItemSelf-Pay BillingSelf-Pay BillerWeeklyWeeklyGlobal Billing WorkflowsWork ItemInsurance BillingInsurance BillerDailyDailyReturn from Collections - Bill InsuranceWork ItemInsurance BillingBusiness Office Supervisor or ManagerDailyDailyReturn from Collections - OtherWork ItemInsurance BillingBusiness Office Supervisor or ManagerDailyWeeklyReturn from Collections - UncollectibleWork ItemInsurance BillingBusiness Office Supervisor or ManagerDailyWeeklySelf Pay Late Charge ReviewWork ItemSelf-Pay BillingSelf-Pay BillerDailyWeeklyProvider Liable - No PayWork ItemInsurance BillingInsurance BillerDailyDailyMultiple Primary - Carve OutWork ItemInsurance BillingInsurance BillerDailyDailyRecurring Credit Card DeclinedWork ItemSelf-Pay BillingSelf-Pay Biller or Follow-up RepresentativeDaily

Weekly

Note

The resolution frequency of this work queue is dependent on patient response times.

Recurring Credit Card FailureWork ItemSelf-Pay BillingSelf-Pay Biller or Follow-up RepresentativeDaily

Weekly

Note

The resolution frequency of this work queue is dependent on patient response times.

Edit Failure Work ItemWork ItemInsurance BillingInsurance BillerDailyDailyInfusion and InjectionWork Item

Revenue Integrity

Coder

Revenue Integrity Staff

DailyDailyReturned MailWork ItemSelf-Pay BillingSelf-Pay Follow-up RepresentativeDaily

Weekly

Note

The resolution frequency of this work queue is dependent on patient response times.

Room and Bed and Length of Stay MismatchWork ItemRevenue IntegrityRevenue Integrity StaffDailyDailyTrauma Team ResponseWork ItemRevenue Integrity

ED Biller

Coder

DailyDailyVoided Benefit OrderWork ItemAccount ManagementInsurance BillerDailyDailyWorkers Comp Statement HoldWork ItemSelf-Pay BillingSelf-Pay BillerDailyDaily
Overview of Patient Accounting Workqueue Recommendations - Patient Accounting Help Pages (2024)

References

Top Articles
Water Heater Leaking From Bottom (Fix & Prevention)
The Best Small Monkey Breeds To Keep As Pets
Earth Defense Force 5: EDF 5 Weapon List
Earth Defense Force 5: EDF 5 Weapon Farming
Dark Souls Dark Bead
Skylar Vox Bra Size
Craigslist Lahaina Hawaii
Oracion Para Atraer Una Mujer
Melvor Idle Atlas of Discovery DLC | GameStop
Melvor Idle - Idle RPG Beginner Guide – Top Adventure Tips and Tricks-Game Guides-LDPlayer
Cursed Text Generator (ርዐየሃ & የልነፕቹ) – Glyphy
Glitch Text Generator (₵Ø₱Ɏ & ₱₳₴₮Ɇ) – Glyphy
Latest Posts
Monkey Breeds That People Keep as Pets: A Friendly Guide - Animal Fanatic
Your First Monkey: Ideal Pet Primates For Beginners
Article information

Author: Barbera Armstrong

Last Updated:

Views: 5343

Rating: 4.9 / 5 (59 voted)

Reviews: 90% of readers found this page helpful

Author information

Name: Barbera Armstrong

Birthday: 1992-09-12

Address: Suite 993 99852 Daugherty Causeway, Ritchiehaven, VT 49630

Phone: +5026838435397

Job: National Engineer

Hobby: Listening to music, Board games, Photography, Ice skating, LARPing, Kite flying, Rugby

Introduction: My name is Barbera Armstrong, I am a lovely, delightful, cooperative, funny, enchanting, vivacious, tender person who loves writing and wants to share my knowledge and understanding with you.