Outstanding Claim follow up

[jesslingle]

Hi. We are going through a period of rapid growth. I would like to hear how other offices follow up on outstanding claims in Softdent? We are getting different claims on the outstanding claims report vs. the List-Claims option. Also, sometimes we have claims print on the outstanding claims report that are new (not the age selected before running the report.) Any advice? What settings do I need to check?

What do you do to follow up on outstanding claims each week/month?

[Anon · Accepted solution]

I strongly recommending 1 to 1 training; there are so many thing you can be overlooking and an order to doing these steps. if you feel like you could benefit from onsite training, please email me at wendy.potts@csdental.com.  for now, follow these steps below.  

Print the un-submitted claims report, submit all necessary claims

• Click Reports
• Click Practice Management Reports
• Click Insurance Reports
• Click Un-submitted
• OK
• Enter Date Range 01/01/2000 thru today’s date (you want to go this far back to make sure nothing is hanging out as un-submitted in the past
• Remove check to include Pre Auth

Click Insurance, Count of forms not Printed, if any matches print batch Claims

• Click Insurance
• Click Count of Forms Not Printed
• If Matches – Do the next step

Print Batch Claims, Click Insurance, Click Print Batch Claim

• Click Insurance
• Click Print Batch Claims

Submit Any Claims Waiting in the ECS Batch

• Click Insurance
• Click Kodak Electronic services
• Load/Validate/Fix Errors/Transmit

Post All Insurance Payments that you have in the office

Run The Zero Account Balance Report with Insurance Remaining

• Reports
• Account
• User Selected
• Zero Account Balance with Ins Remaining
• Looking for account with a Zero balance and Insurance balance over .01

Run The Outstanding Claims Report By Company

• Click Reports
• Click Practice Management
• Click Insurance Reports
• Click Outstanding Claims By Company
• List Claims over 30 Day
• Remove Check Mark for PreAuths

[dianed]

Did you get a chance to put into action some of the things mentioned below? Is your report starting to make more sense? 

[presleywhtie]

Hello!

Unsubmitted claims if they're in the batch will show up on the outstanding claims report. If you validate and submit and then rerun the report, they'll no longer show.

With certain claims showing up that aren't showing up on the batch to be sent makes me think that their are certain procedures hanging it up. Look at an example patient's transaction ledger and click on "claim status" in the top right of the window and if you see any "insurance not sent" that will be the reason that it's showing up as "outstanding" but was never submitted to batch.

Are you following up with your claim submissions by going to the reports section in the ECS screen? From there you'll  be able to check the status in regards to the claim going from the clearing house and being accepted by the payer.

**Another thing of note. In some cases if when entering in a payment for the insurance, if you don't select "Yes" to the question "is this the final insurance payment for the primary" it will stay on the outstanding insurance report despite the claim being paid on. Not saying this is the case but I've seen it happen many times before. 🙂

[jesslingle]

Thank you. We do run the unsubmitted claims report daily so I would not expect this but I will check to see.