'Procedures Not Billed to Insurance' report

[richardwaite]

We're having a problem where the 'Procedures Not Billed to Insurance' report is pulling in procedures that have been billed to and have received payment from insurance. The only thing I could find on the forums mentioning anything like this was this post from 02/2008:

http://70.90.133.65/forum/viewtopic.php ... 651&p=2906

A little bit of checking and it seems that drtech was right. Every procedure that is incorrectly pulled into that report has a second, "errant" estimate attached to it. From what I can tell, they all have estimated payments of $0.00 and are attached to insurance plans that the patient does not even have. It also appears that the insurance plans on the errant estimates are within the same family.

My question is this: could there be a legitimate reason for these estimates being created, or is it most likely a bug? If it is an application bug, my first guess at the cause would be something causing the estimate logic to create estimates for family members for some reason. No idea why at this point.

This office started using version 5.6.12 and is now on 5.6.37, so it seems to have been happening as far back as we can look.

Any input would be appreciated.

[jordansparks]

I remember this as being a bug that was fixed maybe a month ago. It was a long-standing bug. I don't remember how far back the bug fix went. Did you try running the database maintenance tool? It might be time to go to 5.7 or 5.8. There is also a chance that the bug fix only prevented new errant estimates from being added and did nothing about cleaning up the old ones. It's hard to remember, and I can't seem to track it down quickly.

[drtech]

I know the error was fixed in v 5.8.? something and for all v5.9 beta versions. After we upgraded to 5.8.16 i think it was and ran database maint tool it fixed the problem.

[atd]

I don't know if this problem I had is related to this post or not. Here's the problem I had...
I dropped an insurance plan, added the new one and then needed to send the claim to the new insurance. The claim had already been created and sent under the old insurance so I deleted that claim first.
Problem 1: I had one procedure originally set to "NoBillIns", but when I deleted the claim it no longer said "NoBillIns" for that item. I tried to edit that procedure, but it wouldn't let me check the "Do Not Bill to Insurance" checkbox - I'd click it and nothing would happen. I found that if I changed the status from "Complete" back to "Treatment Plan" it would let me check the NoBillIns box - I then set it back to complete and it stayed checked.
Problem 2: I then created the new claim for the remaining procedures, but the appointment module was still showing the red exclamation point in the upper right corner and the individual procedures still showed "unsent" even though the new claim was linked to all of those procedures. After looking further I found that the original insurance estimate was still attached to each procedure, even though that claim had been deleted. So there were 2 estimates - one for the old deleted claim, one for the new claim. Once I deleted the old estimates then it no longer said "unsent" in the account and the red exclamation went away in the appt module.

Did I make a mistake when I deleted the original claim? How should I handle this situation in the future - do I need to delete the claim before I drop the insurance plan or does that make no difference? Please tell me I don't have to manually delete the insurance estimate from each procedure every time I need to rebill to a new insurance. Because our Medicaid patients are being switched between different health plans frequently.

[jordansparks]

I have put that down as a bug.

[jordansparks]

I just tried to duplicate it. I added a procedure D2392, created a clai, changed status of claim to sent, dropped the insurance plan, added a new plan, and deleted the old claim. When I went to edit the procedure, I saw two estimates, but upon clicking the "do not bill to ins" checkbox, the old estimate disappeared. I repeated the sequence again, but after opening the edit procedure window, I then simply clicked OK. Reopening showed that the old estimate had disappeared just as expected. So I could not duplicate your bug. I suppose I should have asked what version you were on before I even bothered to try to duplicate. I was using version 6.2, which is identical to version 6.1.5.