Print Report
Payment Pending By Insurance Company
Menu Path: PRINT/Reports/Payment Pending By Insurance Company
Screen 1 Main Menu-PRINT
ê
Screen 2 PRINT/Reports
ê
Payment Pending By Insurance Company
12/03/98 Your County EMS Page 1 Payment Pending Report By Insurance Company (AARP) AARP Claim Unit
Filed Refiled D.O.S. Invoice # Patient Balance
----------------------------------------------------------------------
09/01/98 08/02/98 S-M7-398017 WESLECEL 56.70
09/18/98 08/05/98 S-M2-398014 WESLECEL 29.19
-------------
85.89
=============
(ALLS-BIR) Allstate Insurance 999-999-9999
Filed Refiled D.O.S. Invoice # Patient Balance
----------------------------------------------------------------------
04/23/98 09/15/98 04/03/98 A-M7-777641 FREYHELE 390.00
05/06/98 09/01/98 04/03/98 A-M3-947513 HARRIPAT 390.00
-------------
780.00
=============
ETC (UNIT-TX) United Benefit Life 800-999-9999
Filed Refiled D.O.S. Invoice # Patient Balance
----------------------------------------------------------------------
08/05/98 09/21/98 07/12/98 P-M1-396548 LACKESHA 370.00
08/05/98 09/21/98 07/23/98 P-M1-398437 LACKESHA 740.00
-------------
1,110.00
=============
Total A-Auto Ins..... 4,600.00
Total P-Primary Ins.. 35,362.23
Total S-Secondary Ins 6,271.71
-------------
Grand Total 46,233.94
=============
|