I've been able to catch 1-2 unsent claims each month by pulling the claims report using invoice status, but does anyone know why an invoice wouldn't add a claim form to batch? The only reason I can think of is my biller didn't enter an insurance on the original invoice. From what I can tell, all of these unsent claims show the invoices have been edited (at least one line item in blue text) after they were created. There's no claim history of these ever being added or removed from batch, so it has to be occurring when the invoice was edited. I would think the default setting would be a claim being added to batch once an insurance is entered, regardless of original invoice or edited. The User Log Report for each of these pts isn't much help, since it only provides general info of user activity. Am I on the right track? Anyone else run into this issue? If so, what is the best way to resolve?
Yes, I have found (and just confirmed) that if you edit the insurance on an invoice (either to apply to insurance or to change to a different insurance) it is not automatically sent to batch, even if the newly assigned insurance is set to automatically batch. They must do the batching when the invoice is first saved (like the recall update discussed below). You will get a claim change warning to regenerate the claim when an insurance is changed. The only rec I have is to check the CMS form and make sure the button at the bottom says "Remove from Batch", which means it's already in the batch. If it says "Add to Batch" they'll have to click that button to add it. Also, if you edit the assigned insurance, you will have to delete the claim under the original insurance from the batch.
Note: In my testing, I found a mislabeling of the claim status button that I believe is new. When I created a claim with the correct insurance from the start, the batch button said "Add to Batch" even though it was listed in the batch when I checked it. As far as I know, in the past, all the claims automatically batched said "Remove From Batch" from the start.
FYI, not all changes to an insurance item will trigger a regenerate warning so I tell employees to regenerate an invoice anytime an edit is made on an insurance patient invoice.
I don't see any reports that will show that info, although you'd think they would exist. I thought the Claims Report would work since it lists batch info (and it has an Add to Batch button) but I just created an edited invoice that wasn't batched and it doesn't show up in that report. The Insurance Receivables Report doesn't list batch status so that won't help.
Along the same lines, if you marked some of your exam billcodes as "full exam" so billing those codes would trigger a recall update, that update is only triggered if the codes are there when the when the invoice is first saved. So if the optician starts an invoice with an eyeglass order and the exam codes are added later, recall will NOT be updated automatically. We had to set out Admin/Company/General setting to check "Always Display Recall after Creating Invoice" so we wouldn't miss recalls.