Followup Queue

The Followup Queue in MedSuite provides a means of following-up on claims and accounts on the screen, virtually eliminating the need to run lengthy followup or delinquency reports.  Followup "queues," built by criteria determined by each practice, allow "actions" to be taken on a claim or account, track those actions by user, and allow the user to set a future followup date at which point it will re-appear in its queue.

Through the use of the Followup Queue Definitions, practice managers determine if, when, and how an account or a claim will be sent to the Followup Queue. The followup workload in a practice is typically divided among several workers by type of followup (insurance or self-pay).  Within insurance there is frequently a further breakdown into specific plans or plan types because workers who have expertise in Medicaid followup generally have contacts at Medicaid who can help speed things along.  For larger practices, within self-pay a further breakdown is required simply due to the volume of followup accounts.  MedSuite uses Followup Queues and Filters to accommodate both the insurance and the self-pay breakdowns.

Let's look at a brief example:

Let's assume that a practice has defined that a Blue Shield claim that has not been paid or denied within 30 days of the submission date should be sent to a Blue Shield Followup Queue.  Furthermore, a Blue Shield claim has met this followup criteria and has been sent to the Blue Shield Queue.  Finally, let's assume that someone called BFW (Blue Followup Worker) does the followup for Blue Shield.

Each day, BFW comes in to work and opens the Blue Shield Followup Queue.  When the Queue is opened, all claims that are to be "worked" today (or days past that weren't worked) will be displayed on the screen.  BFW then begins making phone calls, pulling ledgers, refiling claims, etc.  As these actions are performed, they tell the Followup Queue how far to advance the Next Followup Date.  For example, if the Blue Shield claim were to be refiled, then the Next Followup Date might be advanced fourteen days.  If the carrier were called and said that the check was in the mail, then the Next Followup Date might be advanced five days.  In either case, the actions performed are recorded in Followup History and the Next Followup Date is advanced according to a manager-defined guideline.

Five days into the future when BFW starts working the Blue Shield Queue again, the "check is in the mail" claim pops up on the list just like magic if it has still not been paid.  In the event that in the intervening five days, the claim was paid, then the claim will be closed and the claim will not appear in the Followup Queue for followup processing by BFW.

Followup actions are performed via the Followup Queue. Access the Followup Queue by clicking the Followup Button on the Dashboard Toolbar, or entering the short-cut key combination CTRL+Q, or by selecting Followup Queue from the Queues menu.

Press F9 or click the search on the Queue field to display a list of the Followup Queues.  Select the Queue that you wish to view.  Select the Filter button to go ahead and display the entire Queue without applying any filters to it.