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ADMISSION COORDINATOR

Resident Setup Review Overview

Resident reports validate and check whether all information entered for each resident is accurate and complete. You can run the resident reports to validate the resident information at any time. Here's a summary of each report:

  • Resident Contacts Report lists all the residents' contact information in the database. It can be configured by type of contact and admission date and can be used to validate that all resident contacts have necessary mailing and telephone information, contact relationship and contact types. In particular, you want to be sure that every private-pay resident has a contact type (i.e. A/R Guarantor or Responsible Party) designated to receive the private statements.
  • Resident List Report lists all residents that are entered into the system. You should run this report frequently to ensure that all residents are entered correctly. Check Advanced Options to include resident details such as primary physician, resident identifiers, external facilities, and user-defined fields.
  • Detailed Monthly Census Report lists all transactions incurred during the selected month based on the status codes entered in the resident census lines. This report is configured by designated month and can be grouped in sections showing resident detail or summaries by payer by day, payer by care level, care level, status, unit, and rate type. The report can be pulled by unit or by facility. Use the Detailed Monthly Census Report to compare against census items when billing and to validate census information for each day of the month.
  • Action Summary Report lists resident movement within a predetermined date range and is based on the Action Codes entered in the resident census lines. This may include admissions, discharges, deaths, internal transfers, room or payer changes, and leave of absences. Compare this report to the Detailed Monthly Census Report to validate the resident census information and census counts.
  • Level of Care Report track residents' level of care information.

After you verify the resident information, you also need to ensure that all resident payer and billing information including payer setup and insurance setup is complete. Use the following list of billing reports to validate this information.

  • Recurring Transactions Report shows the recurring charge setup for the residents. For ease in validating specific charges, group the charges by item code such as cable or laundry.
  • Resident Rates Report provides rates by payer and rate effective date for a specific resident or all residents over a specified date range. Use this report to validate standard and/or reimbursement rates are shown for each resident. Any residents with No Rate Found require correction for the system to book revenue and produce accurate billing. This report also shows the general ledger account associated with the rate.
  • Resident Insurance Setup Report lists all residents with insurance setups in the resident payer setup or under the A/R Insurance tab of the resident record and can be used to validate the resident's insurance information The report lists all the information entered in resident records such as policy number, group name, group number, authorization number, and effective/ineffective dates. Compare the Resident Insurance Setup Report to the Payer Setup Information Report to identify residents requiring an insurance setup. The resident insurance information populates the fields on the UB04 or 1500 claim form.
  • Payer Setup Information Report shows the payer setup information as entered under the payer setup in the residents' rate history/census lines. The report also provides information based on the payer billing rules such as if the payer bills in advance, type of bill form, ancillary billing information, deductible/liability amounts/rules, payer coverage limit information, and coinsurance rules. It is best practice to select all payers to validate correct resident count by day and by payer. Validate that payer setups are created and payers are properly sequenced for each resident. Also, verify that each resident has accurate billing information for each payer.
  • Therapy Caps Report shows residents' therapy amount used based on type of therapy, prior and current amounts used, total amount used, and remaining amount. Verify the amounts entered in the Therapy Caps section under the A/R Profile. This report is an excellent means to track and manage residents' annual therapy usage and determine if the resident has exceeded the therapy cap.