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JulieCobb
Canine II

Claims with no transactions

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Hi there,

I am trying to figure out how I have a ton of claims but there are no transactions in the claim. When looking though the aging it shows a balance for the claim & an estimate to the insurance; however when you "R" (review transaction) on the claim there is nothing there.

Can someone tell me why this is happening? Would running the "transfer claims to patient" or "delete old claims" report cause this? 

Thanks! 

1 Solution
JulieCobb
Canine II

We finally figured out what was happening - In the ledger, when you remove the check mark in the 'insurable' box it removes it from the claim. So, instead of the person canceling the claim and then resubmitting it; they were going to each transaction and removing the check mark and then replacing the check mark (in the 'insurable' box) to resubmit the claims.

When they did this, the old claim is still there but there is no actual transactions in that claim - I just delete those blank claims and explained to the staff how to resubmit the claims properly. I really hope that make sense!

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JulieCobb
Canine II

We finally figured out what was happening - In the ledger, when you remove the check mark in the 'insurable' box it removes it from the claim. So, instead of the person canceling the claim and then resubmitting it; they were going to each transaction and removing the check mark and then replacing the check mark (in the 'insurable' box) to resubmit the claims.

When they did this, the old claim is still there but there is no actual transactions in that claim - I just delete those blank claims and explained to the staff how to resubmit the claims properly. I really hope that make sense!

@JulieCobb there are multiple ways to resubmit insurance claims, but the first thing you must figure out is the "why" ... what is the reason that the claim has to be submitted?  But, officially, unclicking the insurable box is not one of the ways to resubmit.  Look under the Softdent Help, specifically under submitting insurance claims, for details.  Softdent makes it very easy to resubmit ... but a word of caution - every time you resubmit it will cost your office $$$, paper or electronic, so try to resubmit only once 🙂

mdunham
First Molar I

We are having a similar issue.  Some claims state that there are no transactions on them (when you select Review Transactions) from the claim tab.  However, when you Print a copy of the claim, most often the transactions are there.    SOMETIMES, the transactions are omitted and of course will not then batch at end of day; when this happens there seems to be some correlation between those Trans-free claims and NEA attachments when submitted from one workstation yet submitted at end of day from another workstations. Its as if if the claim has an NEA created but not sent by the end of the day claims submission then the transactions are wiped out.   

drcavola
First Molar I

@JulieCobb someone in your office is canceling these claims.  As long as that same someone or someone else has submitted the claim once cancelled, and has been paid, all you need to do is delete that claim.  If another claim had never been submitted and there is a balance pending as a result, then you have some follow up work …