Changing Referred Status when Procedure Complete

[jclaydds]

We had an error on a patient's account today. I suspect I know what happened by I am not sure. We had a charge for a root canal applied to a patient's account by mistake. I suspect the root canal was originally put into the patient's chart as a treatment planned item with the appropriate fee. I think the doctor then changed his mind and changed the status to "Referred" since he decided to refer out to a local endodontist but did not think to change the fee to zero. The letter came back from the endodontist saying the root canal was complete and someone on staff wanted to show the root canal had been completed so they marked it as complete.

I suspect we should have not marked the status as "Complete" but as "Existing Other" meaning it was done by another provider. Secondly, if the root canal had initially been entered as a status of "Referred", it would have went in as a zero fee so even if someone did mark it as "Complete", the zero fee would have not affected the patient's balance.

Just trying to figure out how I should handle these entries in the chart that are "Referred" and what status we should use once the specialist completes the treatment. Most of all, I want to avoid adding a few hundred dollars to a patient's account by mistake.

[jordansparks]

I think you explained the situation perfectly. It's just a training issue. It should be fairly easy to spot it as an error because it won't have the proper note edits.

[jclaydds]

To clarify: When a procedure is completed by a specialist that has a "Referrred" status assuming it has a zero fee as well, do you recommend I train my staff to change the status to "Existing Other" or "Complete"? I lean toward "Exisiting Other" since marking it "Complete" makes it appear like it was completed in our own office except all the notes are missing and I suspect it will also make it show up on the patient's account ledger with a zero fee.

[jordansparks]

Definitely to EO. Complete is inappropriate.

[drtech]

we always leave ours referred and just update a new tooth note...
should there be an added "referred-completed" or "other-completed" to be more accurate and separate tx that was done before you saw the pt and that done after they started with you?

[atd]

I see this happen a lot with our users. Intuitively the work is "complete" so that's what they end up changing it to, not realizing they're billing it out as if they did the work. I've brought it up in follow-up training sessions a few times, but it still seems to happen here and there. Another status for referred-complete would be great.

[jordansparks]

I think the best solution is to warn users when they try to change the status from R to C. EO is perfectly adequate for work that was referred and is now complete.

[DavidWolf]

Perhaps if referred status automatically changed the fee to $0 and checked the do not bill insurance box these issues would be partially eliminated even with user errors....or a warning are you sure you want to change the status from referred to completed???

Also could be like the claims which can not be deleted until the status is changed from received to something else.

Perhaps procedures should not be allowed to be completed until they are changed to treatment planned first????

Just some thoughts.

Thanks