OMG! I just realized that a security clearance is not needed to clear a claim in Practice Works. We had a fraudulent employee do this and got away with it for almost a year before we caught it. For example , this employee cleared all the United Health Care claims and intercepted all the UHC claims from the mailman since she works front office. The person accused was the person responsible for follow up on all the Outstanding claims in our office.
Has this happened to anyone else?
A claim and be cleared 2 ways. Under File/insurance claims or when generating a report for Outstanding Claims under Office Expert... without any security access clearance needed.
To the Practice Works software engineers, Please fix ASAP or you will not have this 18 years customer much longer
Thanks for you message. This is perfect timing as we are actually planning some modifications to the Claims window for 9.1. I apologize you have to learn of this the hard way!
I will get something written up ASAP.
We can add a security for the 'Clear Claim' button.
As far as info around the event, what info would you need to know?
Ex. User / Ins Claim Cleared
You should be able to change that in your access requirements? Perhaps if they would change the status to be "P" for paid and "C" for cleared (instead of it being C for both of these types of transactions), it could have been caught sooner.
So in 9.1, will we also be able to search for cleared claims, or is the update only going to implement a security clearance for clearing claims?
In v9.1, which has already released at this point, within the redesigned insurance claims list you can still filter to view the cleared/refused claims using the same checkboxes as before. They moved locations, but that function is the same as before 9.1's redesign of the claim list. It's just a matter of checking the needed filter options and then clicking the apply filter button.
You can sort and search by patient name on the claims list in the new design, which can make it easier to find the specific claims needed.