Claim Balance Report

Managing Revenue Cycle

Claim Balance Report Overview

The Claim Balance Report provides a comprehensive summary of all unpaid claims, categorized by how long they have been outstanding (aging) and their current status. This report is a critical tool for tracking outstanding Accounts Receivable (AR) and identifying claims that require immediate attention due to denials or billing delays.

• Company Name: Analytiq Inc.

• Primary Carrier: Medicaid.

• Cutoff Date: March 01, 2026.

• Report Generation Date: March 20, 2026, at 07:59 PM.

• Total Outstanding Balance: $537,423.78.

Understanding Aging Categories

The aging table allows users to see the health of their billing cycle at a glance by showing how long money has been owed to the agency:

Category	Amount Outstanding
Current (0-30 days)	$0.00
30 – 120 Days	$0.00
120 Days	$13.00
150+ Days	$537,388.78

Critical Note: The vast majority of the agency's outstanding balance ($537,388.78) is over 150 days old, indicating a significant need for aging AR recovery.

Field Definitions for Users

To manage individual claims effectively, users should understand these key columns:

Field Name	Description
Claim ID	The unique tracking number for the claim in FieldWorker.
Service Date	The date the care was actually provided to the patient.
Status	The current stage of the claim (e.g., Denied, Ready to Bill, Released).
Outstanding Balance	The specific dollar amount still owed for that individual claim.

Common Claim Statuses & Use Cases

1. Denial Management (Status: "Denied")

A large portion of the report features claims with a Denied status, such as Claim ID 6001 for Jeffrey Geisler ($362.89).

• Use Case: Billing specialists should use this list to identify why Medicaid rejected these claims and resubmit them within the timely filing window.

2. Billing Preparation (Status: "Ready to Bill")

Claims marked as Ready to Bill, such as Claim ID 6801 for James Williamson, represent completed services that have not yet been sent to the carrier.

• Use Case: Administrators should process these claims immediately to ensure they do not move into the 150+ day aging category.

3. Deferred or Rejected Claims

Claims marked as Deferred (e.g., Claim 8848) or Rejected (e.g., Claim 7591) require manual intervention to correct data errors.

• Use Case: These typically indicate missing patient information or incorrect Medicaid IDs that must be fixed before the claim can proceed.

Professional Best Practices

• Weekly AR Review: Users should generate this report weekly to ensure that "Ready to Bill" claims are moving to "Released" status promptly.

• Focus on Aging: Prioritize the 150+ days category. Many insurance carriers, including Medicaid, have strict deadlines for "Timely Filing," after which you may no longer be able to collect these funds.

• Zero-Balance Verification: If a claim like Claim 23 shows a balance of $0.00, verify if it was fully paid or if it was an "Invoice Raised" that needs to be cleared from the system.