{% extends 'base.html' %} {% load static %} {% block title %}Insurance Claims - Billing{% endblock %} {% block content %}
| Claim Number | Bill Number | Patient | Type | Insurance | Submission Date | Billed Amount | Paid Amount | Patient Responsibility | Status | Days Pending |
|---|---|---|---|---|---|---|---|---|---|---|
|
{{ claim.claim_number }}
{% if claim.prior_auth_number %}
Auth: {{ claim.prior_auth_number }} {% endif %} |
{{ claim.medical_bill.bill_number }} |
{{ claim.medical_bill.patient.get_full_name }}
MRN: {{ claim.medical_bill.patient.mrn }} |
{{ claim.get_claim_type_display }} |
{{ claim.insurance_info.insurance_company }}
{{ claim.insurance_info.policy_number }} |
{{ claim.submission_date|date:"M d, Y" }} | ${{ claim.billed_amount|floatformat:2 }} |
${{ claim.paid_amount|floatformat:2 }}
{% if claim.allowed_amount %}
Allowed: ${{ claim.allowed_amount|floatformat:2 }} {% endif %} |
${{ claim.patient_responsibility|floatformat:2 }}
{% if claim.deductible_amount %}
Deductible: ${{ claim.deductible_amount|floatformat:2 }} {% endif %} |
{% if claim.status == 'DRAFT' %}
Draft
{% elif claim.status == 'SUBMITTED' %}
Submitted
{% elif claim.status == 'PENDING' %}
Pending
{% elif claim.status == 'PROCESSING' %}
Processing
{% elif claim.status == 'PAID' %}
Paid
{% elif claim.status == 'DENIED' %}
Denied
{% elif claim.status == 'REJECTED' %}
Rejected
{% elif claim.status == 'APPEALED' %}
Appealed
{% elif claim.status == 'VOIDED' %}
Voided
{% endif %}
{% if claim.denial_reason %}
{{ claim.denial_reason|truncatechars:30 }} {% endif %} |
{{ claim.days_pending }} days
{% if claim.response_date %}
Response: {{ claim.response_date|date:"M d" }} {% endif %} |
|
No insurance claims found. |
||||||||||