Accounts Receivable
Expected revenue based on the authorized services rendered
Managing Revenue Cycle
This dashboard lists all expected (or estimated) revenue for the selected month, from your client population. For NJ Support Coordination companies, the expected revenue is estimated based on the client population and their plan status. This is a key dashboard for managing your receivables and tracking them across payers and over the period.
The Accounts Receivable tab within the Billing module provides a granular, line-item view of your agency's expected revenue. While the Financial Summary gives you the "big picture," this tab allows you to track specific payments, authorizations, and project dates for every individual member.
π
1. Filtering and Navigation
At the top of the page, you can control the data range for your audit:
Month Selector: Use the [ο ] and [ο‘] arrows or the date picker to move between billing cycles.
Total Receivable: A real-time calculation of the total dollar amount for all rows currently displayed in the table.
π 2. The Accounts Receivable Table
This table is the core of your financial tracking. Each row represents a billable event or a project phase for a specific customer.
Column
Description
DDDID
The unique identification number for the member.
Customer Name
The name of the client receiving services.
Plan Version
Indicates which iteration of the care plan is currently active.
Project Dates
The Start and End dates for the specific authorization or service period.
Proc Code
The procedure code used for billing (e.g., T2024HI).
Unit / Rate
The number of units provided and the agreed-upon rate per unit.
Total
The calculated amount for that specific line item.
Account Code
Categorizes the entry, such as ACTIVE PLAN or INITIAL PLAN.
Prior Auth Status
Crucial for compliance; indicates if a valid Prior Authorization is linked (e.g., "No PA Found").
Payment Status
Shows where the money is, such as Voucher Payment Received or No Payment Found.
π οΈ 3. Table Tools and Exports
Located directly above the table on the right, these tools allow you to manipulate how you view the data:
Column Visibility: Toggle which columns are visible to simplify your view.
Filter: Search for a specific member name or status within the current month.
Export (π€): Download the current view as a CSV or Excel file for external accounting.
Save (πΎ): Save your preferred grid layout for future sessions.
π 4. Top-Level Action Bar
The icons at the top right of the Billing page allow you to jump between different financial sub-modules:
Table Icon (Current View): Accesses this Accounts Receivable list.
Checkmark Icon: Opens the Claims list for reviewing individual service submissions.
Sync Icon (π): Refreshes the data to reflect recent changes from Timesheets or the Scheduler.
Paperclip Icon: View attachments or supporting financial documentation.
Report Icon: Generate specialized billing exports.
Audit Tip: If a row shows "No PA Found" in the Prior Auth Status column, the claim may be denied by the payer. Ensure you update the member's authorization in the Members tab before releasing the claim.
The dashboard has the following columns.
DDD ID
Customer Name
Plan Version
Project Start Date
Project End Date
Proc Code
Unit (from Prior Auth file, where available)
Rate (from Prior Auth file, where available)
Total (from Prior Auth file, where available)
Account Code (classification leading to the calculation of expected revenue)
Post Date (date on which the entry was posted the first time)
Prior Auth Status (matching of prior auth entry, where available. User can assign status for entries if there is no prior auth available)
Payment Status (where available. Users can assign a status for entries if there is no claim status available.)
Payment Date (where available)
Notes (where available. Users can edit and/or append a note.)
Users can select, download, and print any combination of the data, as needed.
π The Data Flow Pipeline
The entries in the Accounts Receivable tab are automatically populated through a "data chain" that connects clinical operations to financial reporting. No manual data entry is required on this page; instead, it aggregates information from three primary sources:
1. Member & Authorization Setup
The foundational data for every row (like DDDID, Customer Name, and Project Dates) is pulled from the Members module.
Plan Version & Account Code: When a memberβs plan is activated or renewed, the system creates a corresponding entry in the AR list.
Prior Auth Status: The system cross-references the current date against the "Authorizations" uploaded in the member's profile. If no valid authorization covers the service date, the column will display "No PA Found."
2. Service Scheduling & Procedure Mapping
The Proc Code, Unit, and Rate are determined by the configuration of the task in the Scheduler.
When a session is scheduled, it is assigned a Task Type.
These Task Types are mapped to specific billing codes (e.g., T2024HI) and rates in your Advanced Settings.
The "Unit" is calculated based on the duration of the scheduled or performed session.
3. Documentation & Approval
For a session to move from a "plan" to a "receivable" item with a Post Date, it must move through the documentation loop:
Fieldworker Action: The staff member must complete the activity and submit their Timesheet.
Administrative Approval: Once a supervisor approves the timesheet or verifies attendance in the Scheduler, the system "posts" the entry to the Accounts Receivable ledger.
4. Payment Integration
The Payment Status and Payment Date columns are updated based on external inputs:
Remittances: When an Electronic Remittance Advice (ERA) is uploaded, or a manual payment is logged, the system matches the payment to the member's DDDID and service date.
Voucher Tracking: For voucher-based services, the status shifts to "Voucher Payment Received" once the fund allocation is confirmed.
π οΈ Summary of Population Triggers
If you see a member on your roster who is missing from the Accounts Receivable list, check that they have an Active Plan and that at least one billable session has been scheduled for the selected month.
Last updated