Open Dental missed some completed procedures for billing

[Creation125]

I have recently noticed that a few of the patients account module has procedures that were not sent to insurance. They would just show complete without the usual "(unsent)" after it. "Procedures not billed" in reports will not catch these completed, but not yet billed/sent procedures.

I'm afraid that there are other patients that will have the same problem, and if we miss the 90 days/1 year limit on filing a claim, the office will be losing a lot of income. I do notice that the procedures don't have an "Insurance Estimates and Payemtns" when I click on them.

Does anyone have the same problem, or know of a solution. Thanks!

[jsalmon]

My only guess is that the patient no longer has insurance. That is the only logical way I could see the (unsent) text disappearing on you. And that would not show that procedure in the report because obviously you wouldn't want all completed procedure from patients without insurance to show up in that report.

[bpcomp]

Was the NoBillIns flag set on those procedures and secondly was it different procedures or the same ones across multiple patients?

[Creation125]

Thanks for replying!

The insurance did not change and was not dropped. The previous completed procedures did not have the same problem. And was billed the normal way.

The procedures were just restorations of primary teeth, and is different a across the patients. Also, "no billing" is not checked.

[bpcomp]

Is there anything done differently, new person up front etc? Are the restorations only for posterior teeth?

[Creation125]

Same person in the front.

Yes, fillings were posterior teeth, is that significant?

[bpcomp]

Well it could be. Many of the codes for fillings on posterior teeth are setup to insert a substitute code (amalgam). You can see with the same patient if it will repeat the process and not que to send to insurance. Then edit the insurance and look for the check box on the middle left that says "Don't substitute codes." and check that box. Then try again and see if it fixes the problem. I couldn't tell you exactly why the issue but that is my current guess as to what is causing the issue.

[Creation125]

Thanks for the reply. I tried to replicate the problem by adding posterior composites to the same patient, but it seems to be working properly. It's times when it suddenly doesn't work that scares me, and I don't know when that happens. I've never clicked the "Don't substitute codes" box for any insurance plans...