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kpratt
Canine III

Procedure on "Hold"

Is there a way to search for procedures that have been placed on "hold".  We have had an instance when a patient's procedures were placed on hold at their final appt.  The employee failed to go back and submit the claim.  Fortunately, it was caught, but I am concerned that it may have happened previously but possibly on caught.

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3 Replies
Moderator
Moderator

Re: Procedure on "Hold"

Kristy,

   I'm looking in to see if we already have an expert created to track these kind of claims. If not I will look at seeing if it's possible to create one.

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bayarea
Canine III

Re: Procedure on "Hold"

Do you mean "hold" as in the patient was waiting a bit before continuing with the rest of the treatment plan? If the work that was done at their final visit was posted it would show up in your Unsubmitted Claims report. I print this at the end of every month.

Also, each day I use a printed schedule with patient's insurance companies handwritten in (and whether the visit will generate a claim) & copays. I count at the end of each day how many claims went to Renaissance. This cuts down drastically on missed insurance claims (and collected copays!).

Moderator
Moderator

Re: Procedure on "Hold"

Kristy,

   I have looked in to this and found there currently isn't a way built into the program to track procedures set to hold status at checkout. I tried to create a custom expert to track insurance claims, but the problem is that no claim file is created when a procedure is placed on hold. So there is no claim to track or display in PracticeWorks.

   This issue has been submitted to Development as an enhancement request.

   In the meantime I've come up with a fairly simple work around to have something show on your daily reports at the end of day to remind you to find the claim and resolve the reason it was placed on hold.

Go to lists>transaction codes.

Select the radio button to display adjustments.

Click add.

Fill in the fields as shown in graphic below:

Click ok to save it and close the transaction code list.

   Now during checkout, if a member of your staff changes the "Ins" column status to hold, have them then add this adjustment by typing "HOLD" in the next available description line and hitting tab. No need to enter an amount for the adjustment (it can be left as 0.00) and then finish the checkout process.

   When you run your daily reports at the end of day (file>print>accounts and receivables>daily report or periodic report) make sure to check the box for "List adjusting entries" under the A/R recap or Combined A/R recap depending on how you normally run the report.

   As long as "List adjusting entries" option is check, all adjustments for the day will be listed at the bottom of the report. Then just glance through the report to see if the "Claim on Hold" adjustment entry shows. If one appears, it will list the patient it's associated with and you can then take action needed to resolve it. During that process, you can undo checkout and remove the Claim on Hold adjustment code if you choose (if you leave it on the ledger, it will print on future statements).

   This won't help you track procedures placed on hold in the past, but will at least give you an option of tracking them from this point forward.