Health Fund & Insurance Reports in D4W

Health Fund & Insurance Reports in D4W

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A range of reports covering heath fund comparisons and other insurance funds or outstanding claims.
Exporting, emailing and printing options available for all reports
Links to 50+ other reports can be found at the bottom of this article thread.

Where to find the Reports page

Go to Location Management > Reports Tab

Health Fund Comparison Report

The Health Fund Comparison Report provides the user with a comparison of all health fund rebates that have been entered into D4W/PSS. 

These figures rely on the correct rebates entered into Insurance> Insurance tab> Insurance Plans, and does not calculate rebates entered by insurance claiming systems such as Tyro, HICAPS etc. 

Run the Report
  1. Go to Location Management > Reports tab
  2. Open the Health Fund Comparison Report
  3. Select the funds to include in the report
  4. Click OK
Report Details

The report shows the rebates for each selected insurance; allowing the user to make comparisons between each.

Insurance Funds and Patients List Report

This report generates a list of all patients allocated to a specific Insurance Fund. 

The percentage of patients allocated to each of the Insurance Funds for a selected period of time or all dates is calculated.

Patient details can be viewed on the report so the patients allocated to each Insurance Fund.

Run the Report 
  1. Go to Location Management > Reports tab
  2. Double click Insurance Funds and Patients List report
  3. Select the report parameters
    1. Fund: Select from the drop list the individual or all fee levels to base this report on
    2. Location: Select if applicable
    3. Provider: This is the main provider that is set in the patient details. You can select an individual provider or all
    4. First Seen Date: This refers to the patients first time at the surgery; the first day treatment was entered. The field for first seen date is found in the patient details tab. You can select a date range or select all dates
    5. Show Inactive Providers as well: Tick to include providers no longer working at the practice
  4. Show Totals Only: The report defaults to view the patient details unless you put a tick in the show totals only box
  5. Click OK 

Report - Full Details Showing

If the report is left as the default of viewing the patient’s details, the below details will be shown.

  1. Patient No.
  2. First Seen Date
  3. Patient Surname
  4. Patient First Name
  5. Provider Code

At the end of each fee level there will be a sub-total showing a count and percentage of patients allocated to the Insurance Fund.

Report - Totals Only Showing

If Show Totals Only is selected, a listing of all the sub-totals for each Insurance Fund with the total count and percentage allocated is displayed.


Outstanding Insurance Claims - NON HICAPS Report

The Outstanding Insurance Claims report is used for manual claims generated in Treatment via the Generate Insurance Claim Form in Create Itemised Invoice window that has an outstanding balance.

Run the Report
  1. Go to Location Management > Reports tab
  2. Open Outstanding Insurance Claims - NON HICAPS
    1. Date: Select the period to base this report on
    2. Show full details: Tick to view the individual item numbers
    3. Show Data
      1. Unpaid Claims: Only claims that are fully unpaid will be included
      2. Partly Unpaid Claims: Only claims that are partially paid will be included
      3. Both Types: Select to see both Unpaid and Partly Paid
    4. Click OK

Report Details
Date: The date the claim was generated in D4W/PSS
Insurance Company: The Fund the claim is associated with
Notes: Any notes written against the claim in the Claims tab will be shown
Total: The total amount of the claim
Paid: The total amount paid towards the claim

Payment Solutions Claims Reconciliation Report

The Payment Solutions Claims Reconciliation Report generates a list of all e-payment transactions that have been made for a selected date range.

Prerequisites
  1. Hicaps/Tyro Terminal
  2. Hicaps/Tyro link from Dental4Windows
  3. Generate Hicaps/Tyro claims from Dental4Windows
Run the Report
  1. Go to Location Management > Reports tab
    1. Open HICAPS Claims Reconciliation Report if using Hicaps
    2. Open Tyro Claims Reconciliation Report if using Tyro
  2. Set the report parameters
    1. Date Range: Select the period to base this report on (date of the claim)
    2. Location: Select the Location or <Any Location> if applicable 
    3. Provider: Select the Provider or <All> if applicable 
    4. Show Inactive Providers as well: Tick to include an Inactive Provider
    5. Fund: Select the fund or <All Funds> if applicable 
    6. Click OK

Report Details
  1. The report is based on the selection in the report parameters.
  2. When the report is run, transactions will only appear in the report if there has been claims made in the selected date range.
  3. If choosing All Providers, the report will show all claims for each individual provider with an overall total at the end of the report.
  4. If choosing All Funds, the report will show each fund with an overall total at the end of the report.
  5. At the end of each health fund there is a subtotal for that fund.
Transaction
Type: This shows whether it is claim or Cancellation etc
Date / Time: The date and time of transaction
Response: This shows if it was approved or not
Status: This shows if it is done or cancelled etc.
Patient: Patient name and card no
Ins Memb #: Patients insurance number
Prv ID: Provider ID No
Claim
Id: Claim Id no
Amount: Claim Amount
Status: This shows if there were any deletions or cancellations
Payment
Id: Payment Id no
Amount: Amount paid by health fund
Date: Date payment made
Subtotal for 
Claimed: The total amount claimed for the selected period for all health funds
Paid: The total amount paid for the selected period by all the health funds
AlertThis report will only include claims made through the terminal from D4W. Any receipts created with the Hicaps Manual or Tyro Manual payment methods will not be included in this report.
 

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