Workflow Admin Tab Definitions by Module

Insurance A/R

The Insurance AR Module it to divide the Claims that need Insurance AR follow up. This module allows administration/leadership to prioritize claims that need to be worked today. Also carve out claims that do not need to be worked today.

Insurance A/R by User

Columns	Definition
Representative	The name of the representative in which claims are assigned to work
Claim Count	The total number of claims that qualify for the worklists.
Claim Balance	The total claim balance of claims that qualify for the worklists.
Cash Opportunity	The total cash opportunity of the claims that qualify for the worklists.
Workload Percent	The percent of claims that qualify for the worklists assigned to a represented compared to the total number of claims
Average Age	The average age of the claims that qualify for the worklists.
Claims Follow Up	The number of claims that qualify for the worklists that the representative have worked (adding a activity, status, and action code along with a follow up date and note on a claim).
Assigned Items Worked	The number of claims that are assigned to a representative that have been worked
Percent Worked	The percent of claims that have been worked by the representative of all claims that qualify for the worklists assigned to them.
Average Follow Up	The average days that the representative puts on claims worked for follow up.
Claims Today	The number of claims that have been worked today by the representative.
Balance Today	The total balance of the claims that have been worked today by the representative.
Cash Opp Today	The total cash opportunity of the claims that have been worked today by the representative.

Insurance A/R by Worklist

Columns	Definitions
Worklist	The worklist name in which claims qualify based on configurations.
Representative	The name of the representative in which claims are assigned to work
High Risk	Ability for Administration/Leadership to mark a list as High Priority for the representative to know they should focus on this worklist first.
Priority	The order in which the worklist appears on the "workflow priorities" section on the configuration page. (this is also the order of worklist that pull claims to qualify for the worklist)
Category	The type of the worklist. (denial, system or regular)
Specialty	They specialty for the claims that qualify for the worklists.
Claim Count	The total number of claims that qualify for the worklists.
Claim Balance	The total claim balance of claims that qualify for the worklists.
Cash Opportunity	The total cash opportunity of the claims that qualify for the worklists.
Workload Percent	The percent of claims that qualify for the worklists assigned to a represented compared to the total number of claims
Average Age	The average age of the claims that qualify for the worklists.
Claims Follow Up	The number of claims that qualify for the worklists that the representative have worked (adding a activity, status, and action code along with a follow up date and note on a claim).
Percent Worked	The percent of claims that have been worked by the representative of all claims that qualify for the worklists assigned to them.
Average Follow Up	The average days that the representative puts on claims worked for follow up.
Claims Today	The number of claims that have been worked today by the representative.
Balance Today	The total balance of the claims that have been worked today by the representative.
Cash Opp Today	The total cash opportunity of the claims that have been worked today by the representative.

Insurance A/R by Client

Columns	Definitions
Client	The Client Name for which the claims qualify on worklists.
Claims Total	The total claims that qualify for worklists for the specific client
Claim Balance	The total claim balance of claims that qualify for the worklists.
Cash Opportunity	The total cash opportunity of claims that qualify for the worklists.
Claims Today	The number of claims that have been worked today by the representative.
Balance Today	The total balance of the claims that have been worked today by the representative.
Cash Opp Today	The total cash opportunity of the claims that have been worked today by the representative.
Claims Follow Up	The number of claims that qualify for the worklists that the representative have worked (adding a activity, status, and action code along with a follow up date and note on a claim).
Percent Worked	The percent of claims that have been worked by the representative of all claims that qualify for the worklists assigned to them.
Average Follow Up	The average days that the representative puts on claims worked for follow up.
Claims Assigned	The claims that are assigned to representatives to work.
Claims Assigned Balance	The total balance of the claims that are assigned to a representatives to work.
Claims Assigned Cash Opportunity	The total cash opportunity of claims that are assigned to a representative to work.
Claims Unassigned	The claims that are not assigned to a representative to work.
Claims Unassigned Balance	The total balance of claims that are not assigned to a representative to work.
Claims Unassigned Cash Opportunity	The total cash opportunity of claims that are not assigned to a representative to work.

Insurance A/R Running Totals

Columns	Definitions
User	The user name of the representative
User ID	The user id of the representative
Today	The timing for items worked.
Items Worked	The total number of items that have been worked by the user.
Bal. Worked	The total balance of the times that have been worked by the user.
Yesterday	The timing for items worked.
Items Worked	The total number of items that have been worked by the user.
Bal. Worked	The total balance of the times that have been worked by the user.
This Week	The timing for items worked.
Items Worked	The total number of items that have been worked by the user.
Bal. Worked	The total balance of the times that have been worked by the user.
Avg. Worked	The average number of items worked for the time period.
Avg. Bal. Worked	The average balance of the items worked for the time period.
Last Week	The timing for items worked.
Items Worked	The total number of items that have been worked by the user.
Bal. Worked	The total balance of the times that have been worked by the user.
Avg. Worked	The average number of items worked for the time period.
Avg. Bal. Worked	The average balance of the items worked for the time period.
The Last 4 Weeks	The timing for items worked.
Items Worked	The total number of items that have been worked by the user.
Bal. Worked	The total balance of the times that have been worked by the user.
Avg. Worked	The average number of items worked for the time period.
Avg. Bal. Worked	The average balance of the items worked for the time period.
This Month	The timing for items worked.
Items Worked	The total number of items that have been worked by the user.
Bal. Worked	The total balance of the times that have been worked by the user.
Avg. Worked	The average number of items worked for the time period.
Avg. Bal. Worked	The average balance of the items worked for the time period.
The Last Month	The timing for items worked.
Items Worked	The total number of items that have been worked by the user.
Bal. Worked	The total balance of the times that have been worked by the user.
Avg. Worked	The average number of items worked for the time period.
Avg. Bal. Worked	The average balance of the items worked for the time period.