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WinOMS: Charges are Splitting into Seperate Claims

WinOMS: Charges are Splitting into Seperate Claims

Symptoms:
Charges are splitting onto separate claims when posted.


Cause:
Something is different about each of the charges. This can include referral, authorization number, service facility. etc.


Solution:
 Edit each charge, and verify that each item on each charge is exactly the same.  If anything is different about the charge it will split to a separate claim.  Some items to check:

  • Referral attached to charges
  • Authorization number
  • Medical or dental ailment
  • Service facility attached to charges
  • Incorrect cross code or missing cross code
     
     
Comments
omsnashville

Another great item to check is the submission method (paper/electronic) within each charge. It is listed under the charge dollar amounts when you open the charge. These were typically the culprit for us when we had claims splitting unnecessarily.

annag

To get all procedures to merge onto one claim, edit all procedures and type "0" into the dental ailment and usually this will do the trick.

Version history
Revision #:
1 of 1
Last update:
‎09-14-2016 04:22 PM
Updated by: