Open Dental Forum

We have been having a minor problem with insurance claims with multiple procedures....it seems that occasionally a procedure inadvertantly does not get attached. For example we do a prophy, exam and bitewings make the claim and later notice that the exam did not get billed out with the other procedures.

We will find the procedure later on the procedures not billed to insurance report, or notice the red exclamation point on the patient's appointment in the schedule. If this happens before the claim is sent we delete and remake properly and really that is the end of it.

However when the partial claim gets sent, we then have to submit a second claim for the missing procedure. Not a big deal but it does cause some duplication of effort and when a second insurance is involved after the first claim is not submitted properly it is a complete hassle.

Since I am not at the desk I realy don't know for sure how it happens. It doesn't seem to ever happen when I make a claim or when I delete the partial (unsent claim) and remake the claim.
My front desk insist that it just happens even though they do everything correctly.

I feel like I have seen the case when one of the procedures is not attached but the total fee for the claim adds upto the total for all procedures done for that appointment, including the procedure which is not attached to the claim???
Which is the only credibility I can currently give to this problem.

Before I come down too hard on my staff, I am just wondering is anyone else noticing anything like this?

Thanks in advacnce for your input.

Is the chairside assistant making sure not to let the patient out of the chair until they are completely done with the chart? Perhaps the chairside assistant completes a procedure after the front desk has already refreshed their screen.

We have had the same thing happen. We use Tesia so we submit the claim immediately at the front desk. When the error is caught we delete the claim and resubmit which usually fixes it, but it sometimes confuses the insurance companies. Also, we have several accounts where the red exclamation mark shows up, we delete the claim, resubmit and it still will show that it wasn't sent. Any ideas on this one. I have about 3 families where we have to ignore the exclamation mark.

What version? And have you run the db maint tool?

make sure there are no old ins estimates attached to any procedures. I have found this to cause problems. Maybe Jordan could add that to the dB Maint tool? (removal of estimates from ins plans no longer active)

we are using 5.1.23 prensently. Hope to update soon

We are using 5.6.25. I have had the issue with procedures getting completed after the claim was made...but this seems to be different from that.....

I will keep an eye for it and see if I can get a better idea of when it happens.

Thanks for your responses.