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Canine II

WinOMS generated two claims for same date of service

Randomly WinOMS will generate two claim form/claim numbers for services rendered on the same day of service/same provider.  I have never figured out how to combine the two claims/claim numbers into one claims without manually filling out an ADA form. Does anyone have any advise?

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Community Manager
Community Manager

Hello @cbartley1279

This happens when something different exists on one of the charges, forcing it to split.  (i.e. a service facility attached to 1 charge but not another, or a referral attached to one charge but not another). 
To resolve the issue and “combine” the claims, you would need to find what is different with the charges, correct that, and then “Trash and Rebill” the claim.
Let me know if this helps or if further assistance is needed. 

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Incorrect. I had a claim (just now) that consisted of three procedures and a medical claim was generated. When I initially opened the account all procedure codes were on one claim form and one Claim Number. The only change I made was that I added a Modifier to one line item. WinOMS then moved a single procedure to a separate claim form/claim number and it was not the procedure that I added the modifier too. Your response did not resolve my question. @tshaw  

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@cbartley1279 I apologize that it happened again. Below are some further details that may be of use. If this still doesn't help, it would be best to contact support so they can investigate further ( or 866.722.2567). 

If the charges need to be on the same claim, the dx codes, service facility, authorization, etc on one charge must be attached to the other charges as well. Generally, you can compare the claims side by side and review each field to determine the difference or edit each charge in the ledger to determine the difference.

  • This can include referrals, authorization numbers, service facilities, and different policies, the method on one charge could be set to paper and others electric.
  • The date of service cannot span a calendar year (i.e. DOS of 12/30/2021 and 1/3/2021 would create two claims).
  • Check the ICD-10 codes for each charge. If charges do not contain the same diagnosis codes, they will also split. 
  • Referrals attached to charges can be checked here Open Ledger> Edit Charge>Extended>Referral Source.
  • Authorization number - to review, open the ledger,  Edit Charge>Extended>>Medical Authorization or Dental Authorization.
  • Medical or dental ailment - to review, open the Ledger> Edit Charge.
  • Service facility or provider cannot be different. To review, open the ledger > Edit Charge.
  • Incorrect cross code or missing cross code - Edit the procedure to ensure it is configured correctly. Tables>Procedure>Codes>.
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