Intellect™
SAMPLE FOLLOW UP LETTERS
Effective version 18.12.07, offices who would like the Organization Name and Physical Address to print on either itemized or non-itemized follow up letters can now do so with a request for Support to add ‘DR_PHYSICAL_ADDRESS' and 'DR_PHYSICAL_CITY_STATE’ to Report Designer. Sample letter:
Effective version 17.12.20, when a follow up letter is requested, additional information displays on the follow up letters when a patient has a date of injury:
The information is pulled from the system as indicated:
• If the patient was registered under Registration --►Worker and an Insurance exists, the <DOI> (and any additional existing DOI) on the Insurance screen print.
• If the patient is registered under Registration --►Regular and an Encounter screen is populated with an <Injury Date> and the <Encounter #> is attached to the charge, the <Injury Date> on the Encounter screen prints.
Scroll through the samples, OR click on a link in the alphabetized list below to view a specific letter sample.
Note: For offices generating letters with the standard database, populate the Billing --►Follow Up --► BOP/GOP <Letter Code> field with the code shown in parenthesis behind the name.
30-Day Insurance Tracer Letter, Itemized (I30)
30-Day Insurance Tracer Letter, Non-Itemized (I30)
30-Day Patient Notice Letter, Itemized (P30)
30-Day Patient Notice Letter, Non-Itemized (P30)
60-Day Insurance Tracer Letter, Itemized (I60)
60-Day Insurance Tracer Letter, Non-Itemized (I60)
60-Day Patient Notice Letter, Itemized (P60)
60-Day Patient Notice Letter, Non-Itemized (P60)
90-Day Letter to Insurance, Itemized (I90)
90-Day Letter to Insurance, Non-Itemized (I90)
90-Day Patient Notice Letter, Itemized (P90)
90-Day Patient Notice Letter, Non-Itemized (P90)
Appeal Letter, Itemized Patient (APL)
Collection Letter with options, Itemized Patient (PNOTE)
Collection Notice Letter, Itemized Patient (COLL)
Deductible Applied Balance Due, Itemized Patient (DED)
Indigent Medical Services Letter (IMS)
Insurance Denied Payment Letter, Itemized Patient (DENY)
Insurance Paid Portion Letter, Non-Itemized Patient (ROLL)
Medicare Non-Assignment, Itemized Patient (NASN)
Medicare Non-Assignment, Non-Itemized Patient (NASN)
Payment Sent to Patient Letter, Itemized (PTP)
Require Immediate Settlement Letter, Itemized Patient (RQPAY)
Responsibility Letter, Itemized Patient (PR)
Settlement Letter, Itemized Patient (PDUE)
Tracer Letter to Insurance, Itemized (TRACE)
30-Day Insurance Tracer Letter, Itemized (I30) - return to list
30-Day Insurance Tracer Letter, Non-Itemized (I30) - return to list
30-Day Patient Notice Letter, Itemized (P30) - return to list
30-Day Patient Notice Letter, Non-Itemized (P30) - return to list
60-Day Insurance Tracer Letter, Itemized (I60) - return to list
60-Day Insurance Tracer Letter, Non-Itemized (I60) - return to list
60-Day Patient Notice Letter, Itemized (P60) - return to list
60-Day Patient Notice Letter, Non-Itemized - return to list
90-Day Insurance Tracer Letter, Itemized (I90) - return to list
90-Day Insurance Tracer Letter, Non-Itemized (I90) - return to list
90-Day Patient Notice Letter, Itemized (P90) - return to list
90-Day Patient Notice Letter, Non-itemized (P90) - return to list
Indigent Medical Services Letter (IMS) - return to list
Medicare Non-Assignment, Itemized Patient (NASN) - return to list
Medicare Non-Assignment, Non-Itemized Patient (NASN) - return to list
Settlement Letter, Itemized Patient (PDUE) - return to list
Responsibility Letter, Itemized Patient (PR) - return to list
Payment Sent to Patient Letter, Itemized (PTP) - return to list
Collection Letter with options, Itemized Patient (PNOTE) - return to list
Collection Notice Letter, Itemized Patient (COLL) - return to list
Insurance Paid Portion Letter, Non-Itemized Patient (ROLL) - return to list
Require Immediate Settlement Letter, Itemized Patient (RQPAY) - return to list
Tracer Letter to Insurance, Itemized (TRACE) - return to list
Deductible Applied Balance Due, Itemized Patient (DED) - return to list
Insurance Denied Payment Letter, Itemized Patient (DENY) - return to list
Appeal Letter, Itemized Patient (APL) - return to list
