I am trying to search by insurance company on billing manager but found it only got the claims that have been “billed” by billing status. Wonder if there is any simple change on the codes to have this function pulling all the claims to that insurance company?
Just a thought, often times the billing is done here and there whenever we a little have time, it would be great to have another criteria for “scrubbed claims (ready to bill)”, this way we can put those claims there and do not have to look through them again.
The reason I tried to sort by insurance company is we are oftentimes very late on sending claims, since different insurance companies have different timely filing periods, it would be in better control if we are able to sort the claims by insurance and send out claims accordingly.
If I combine one insurance company and unbilled in the current criteria, the search would find nothing. if I use one insurance company as the only search criteria, i will find all the previous billed claims.
The only circumstance wherein 2 filters are permitted in the Current Criteria box is the default of today and unbilled. If Medicare and unbilled are chosen, the result is just for unbilled.
I presume you don’t know where in the codes the default for today and unbilled have been set, otherwise you would have fixed it by now.
A half of a work-around is to run Reports/Financial/Collection and select for primary insurance. It’s basically an Open Item Listing of all unpaid claims for a particular primary for a particular range of dates. It’s only a half solution because there is no option to select for secondary or tertiary insurers. It’s also inefficient to do the search in Reports.
In the meantime, will go on a hunting expedition for the folder holding the defaults.
It’s rather primitive to hunt through the folders, but (perhaps right church, wrong pew): /openemr/library/freeb/process_bills.php.
Had another idea, Hui.
If the process is automated, it would solve 2 problems. A cron job will improve cash flow and meet the filing deadline in a timely fashion. Paying for professional support to set up the cron job properly would be a good investment of capital.
Thanks a lot for your help, fsgl. It is a good idea to have a cron job set up for generating the claim batch, this is, in my experience, the more automated part.
The problem here is actually more related to the scrubbing process before sending the claims out, unfortunately this has to be done by a real human being, any small thing that gets neglected, such as adding or deleting a modifier, associate the correct icd codes with the cpt codes, etc. It would be very handy to have an additional category being “scrubbed/ready to send out” somehow built in the billing manager, and a mechanism to put scrubbed claims into this category at the same time as we do the scrubbing, and then at a regular interval (every day, week, or bimonthly in your case) pull them out and batch/send them to the clearing house. It is just a thought, for the developers, when considering future improvement.
In the mean time, I tried a number of combinations in the search criteria box, most of them working well, the “insurance company” criteria, however, only pulls the “billed” claims by default, this is unchanged whether I choose “billed” or “all” in billing status, or not using the “billing status” criteria at all. If I choose “unbilled”, it will pull no claims at all. This could possibly a relatively simple mechanical error in the codes I could fix if I know how, could any body share some directions/thoughts?
In general insurers will allow 1 year for the filing of claims.
I would think that the practice has a sense of the extent of the backlog.
The Billing Manager can search by Custom Date of Service instead of Insurance Company, which will render both sent and unsent claims. I looked at our own claims beforehand to be certain that this is a viable alternative.
Initially each claim will have to be checked to see if it had been sent and paid. This can be done by opening another browser tab and examining the Billing View of Past History for that date of service. As staff whittles down the list, only unsent claims will be left.
With smaller numbers of claims to scrutinize each time, staff can also earmark those claims to insurers with short deadlines. Essentially the practice needs to dispatch the big task by breaking it down into bite sized pieces.
I presume that staff has been using the View Log feature to check for errors. Can’t check for errors until claims have been generated. The error log will pick up such things as missing primary payments when sending secondary claims and missing ICD codes.
Office Ally will do another scrubbing. It’s rare after the second editing to have a defective claim.
up here in the northeast we have 1 year with medicare, 6 months with medicaid and most commercials except 120 days with one peculiar insurance and 90 days with cigna
what’s interesting to me while i’ve researched the unbilled report is that the table ‘billing’ is not being populated with the id of the payer_id from insurance_companies.id like the table ‘claims’ so obviously searching by insurance company in the table ‘billing’ where unbilled claims are stored would have no functionality
i’ll look into the mechanism for writing to 'billing’from the fee sheet and see if it’s easy to grab the payer_id and populate the table
like a bolt of lightning from out of the blue, thanks pithonsoft
i checked out the code and this will allow for insurance searching but only for already billed claims, nice work just the same
however, to address hui’s original request, there needs to be some logic added to grab the payer id and update the records in the ‘billing table’ when a claim is first entered and not yet billed out
here’s the code changes for unbilled items from billing table:
since this will only address items going forward the final step for hui will be to update items that are currently in billing by running a php script that sql updates current unbilled items to latest payer_id listed in insurance_data for the patient (even this might not grab correct payer though if the pt ins data has changed since the claim was entered)
if you’re still interested let me know hui and i can provide you with the script
i tested the fix by steve first, it somehow was not working, even with new encounters i made after i had made the code changes, it still would not pull the encounter till it is marked as billed out.
the fix by pithonsoft is actually working, but i noticed there were 2 lines missing in the original library/billrep.inc, they are additional lines in the fix but was not labled as additions. those lines are the same: “$all = False;”. i attached screenshots to show where they are. maybe that was the reason it was not working when steve tested it?
fsgl, i enjoyed reading many of your postings on the forum, as a user, i found many wisdom from them, very helpful.