Knowledge Base Article #813:

Non-Medicare - FINAL CLAIM Pended Claim Report

FINANCIAL - Billing - Invoice Processing: [Cycle other than Medicare PPS Episode cycle]

Click the [View / Print Details] button in the PENDED CLAIMS section.  A second browser will open and display a PDF report.  The report is intended as a follow-up document to assist you in resolving conditions that caused a FINAL CLAIM to be pended (placed on-hold). 

The report contains Patient Name, Patient ID#, Claim 'From' Date, Claim 'To' Date, Type of Bill (applicable to UB-92), Charge Amount, and three columns indicating specific follow-up. 

POC Needed: If YES, then a Plan of Treatment (485) needs to be entered into patient clinical record.

POC MD Sign Needed: If YES, then the Plan of Treatment (485) is outstanding; awaiting the physician signature.

VO MD Sign Needed: If YES, then a Supplemental (Verbal) Order is outstanding; awaiting the physician signature.

The report footer includes Patient Count, Claim Count and Charge Amount Total.

Please click Preview Attachment link at the right to view a sample FINAL CLAIM Pended Claim Report.

Keywords: careportal, non-Medicare, billing, FINAL CLAIM, report, pended claim
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