cancel
Showing results for 
Search instead for 
Did you mean: 
Highlighted
Premolar III

Procedures "on hold" - 2.0

This topic has been discussed in 2017, but only as it relates to running a report to find any services/claims on hold in order to be able to push them through.

I have an issue with how the software is "reading" these procedures as it relates to patient statements.

We have a patient account with a $109 balance who received a statement for $79.  It was forwarded to me for review.  I see that there is a $37 service on "Hold".  I figured the estimate for that service must be $30, but can't right click on it to view because it is not an actual claim.  However, the rep I just spoke with said that the software IS reading it like a claim.  If that is the case, a statement should not have been generated at all since our statement setup is marked to delay until all insurance has cleared.

"On Hold" has to function one way or the other - it can't be BOTH, and this needs to be fixed right away.

 

0 Kudos
Reply
2 Replies
Highlighted
Community Manager
Community Manager

Re: Procedures "on hold" - 2.0

@saint_tammy @robertangus adding you for any possible input/tips.  

0 Kudos
Reply
Highlighted
Moderator
Moderator

Re: Procedures "on hold" - 2.0

I know this is all being looked at as part of the issue with tracking "on hold" status claims. Currently, "on hold" claims is just a status, doesn't actually create a claim, but in the instance you're discussing, it's still estimating that when that claim is created, insurance will pay $30.

Unfortunately, until the claim is created, statement setup option to delay until all insurance clears isn't triggered as their is no open claim.

I've heard possible solutions will be to have the system go ahead and create the claim at checkout so it can be tracked and will delay statements, but I have not heard when/if this will be implemented.

@glen 

0 Kudos
Reply