6.3 Disclosure Drill Down
Drill Down provides the ability to explore the individual charges for a member or trigger item. To enter drill down, select an member name or trigger category displayed on the Disclosure Listing:
Note: Clicking the member name will produce a full list of claims even if the claim has not met any of the disclosure conditions (case management, disability, or trigger diagnosis).
The resulting screens provides the list of charges included in the item sorted by total amount paid by the plan.
Drill down pages may be exported to Excel by selecting the icon in the upper right corner of the screen:
The fields that are displayed in drill-down include:
Provider - The physician, facility, or product vendor that provided care services for the charge.
Date of Service - The date the participant incurred the charge.
Procedure Code- The procedure code identifying the specific health intervention taken by the provider.
Charge Type Description - The type of benefit coverage the charge fell under.
ICD - The ICD-9 (International Classification of Diseases) code attached to the charge.
Diagnosis - A human readable description of the diagnosis.
Paid Date - The date the claim was paid. Outstanding and adverse claims do not have a paid date.
Total Charges - The total amount billed by the provider of care, product, or service.
Plan Paid- The total amount paid by the plan sponsor on the charge. Outstanding and adverse claims do not have a paid date.
Out - The total amount of outstanding / adverse dollars.