WinOMS: Procedure Code is Not Showing on an Insurance Claim

Document created by tshaw Employee on Sep 14, 2016
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Symptoms:
One or more posted procedure codes are missing from an insurance claim form when printed or previewed.

Cause:

  • Procedure code is marked as "not covered by insurance".
  • Cross code is not set up correctly.

IMPORTANT: If a change is made to a procedure code AFTER it is posted to a patient's ledger, the code MUST be deleted and reposted.

1. Click Tables.
2. Click Procedures.
3. Click Codes.
4. Click Display All.
5. Highlight the code that is not appearing on claim.
6. Click Edit.
7. Verify that there is not a check next to Not Covered by Insurance.
8. Verify that the code is set correctly as Medical or Dental.

9. Verify that the cross code is set correctly.

  • Type the code to be used for both medical and dental procedures and click the ellipsis to open the Procedure Code Search window. If the code already exists, click OK, or click New and complete the information for the cross code. Click OK to save the cross code and link it to the original procedure code.

10. Click OK.

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