@sjpadgett The errors are there. The errors are not being reported. We don’t have a dedicated testing group anymore so these broken things have gotten into the codebase.
There is a user going through the system and he is pointing out all of these things in the billing suite that are not right.
Here are a couple of tickets I have in my system for billing issues. Here is the first observation.
I found something that might be of interest to this topic.
I am working on sorting out and correctly resetting the statement counts so I can send all ins due to our biller for follow up. In doing so, I found that the system does appear to know when a given insurance has/has not paid but this isn’t translating to the report writer.
In ss 01 when pulling up a patient and reviewing billing notes, the system reflects that the secondary is due (pointer 0000002). In the collections report from ss 02, the statement has ticked off a count and was reflecting the balance is due to the patient incorrectly.
This almost make it seem that the statement count is allowed to override what is actually happening with the status and bypassing the billing.
I found several more examples of this that also included primary payments being bypassed. I dont understand the logic in the code of course but it appears that the order of the statement should occur only after all insurances have paid and not prior to. Perhaps it’s jumping in there when it shouldnt at all - I’m trying to come up with a scenario why this would be necessary but of course I am lacking the knowledge of any other dependencies that might exist. If there are none, maybe it can be disconnect from what it’s doing to the report writer but re-purposed the prv count and leave it in the system. I’m finding the statement count is useful in giving me the ability to use it as a way to determine what the status of an encounter in the writer and it’s billing status when I’m in that part of the system.
Thoughts?
Edit: Adding how I am adjusting the prv to act more like a aging “Review Code” of sorts so it does both split off the ins vs patient due and also signals what is necessary. I found I can add any positive or negative integer - any letters or other characters result in a “0” result.
Repurposing PRV:
-2 = Primary has not paid
-1 = Secondary has not paid.
0 = Unused
1 = Ins balances paid - patient due balance
2 = Ins balances paid - HCF Due
12 = Ins balances paid - patient due ins and HCF balance
3 = Patient balance due - No Secondary
5 = Private Pay - balance due
Special
-10 = Insurances Due - Problem with coverage/payments.
