Hello! We have been noticing that sometimes when we electronically batch for example: Periodic Exam and Prophylaxis, Softdent will seperate the two and batch them seperately on 2 claims. Why?
This occurs in cases where a patient has had a hygiene procedure and another procedure, however the hygienist is set to be their own doctor on insurance forms. By selecting the appropriate doctor on insurance forms, both procedures will print on one claim form.
This may also happen when a patient has had procedures done by more than one doctor and those doctors are set to be their own doctor on insurance forms. In cases such as this, two claim forms will be generated for procedures done by each provider.
I was just able to pinpoint how it happens, at least in our system. Under the list of providers, if you have a Dr. in the "assign collections to" spot, it will actually print two claims. When I did not have a Dr. there, it printed it on one claim and the on the claim listed the Dr. who did the exam. I think if you don't have an "assign collections to" it just uses the Dr. who did the exam or the one assigned to that patient.
We do have multiple Drs. and 8 hygienists, so our settings may be a little different than others.
Let me know how this works:)
enspire hey Tonya i found this more detailed breakdown for the causes of this issue and the checklist for a solution
- The Production (DR) or Collection (D$) providers are set incorrectly on the posted procedures being submitted. - Hygiene procedures are being submitted, but are not marked as "Hygiene Code" in their ADA code information window. - The "Dr. On Ins Forms" is not set correctly for a provider who performed one of the procedures.
if you can check these points that might cause this to happen
I figured this out, by the way I mentioned above. Just trying to be helpful to the original poster, not sure if her issue was resolved.
enspire , sorry didnt see that , yeah just adding some extra info about that subject for others
I am curious as to the details of these phenomenon you describe. I've seen it too - more times than I'd like to admit.
Please do me a favor and look at the transactions of each of those claims. I would bet that one of those two claims have NO transactions listed. For example, using your periodic exam and prophy. I suggest that the issue is not as Aymen suggests, with two claims, one of the exam and one of the prophy.
I've been working with this issue with a very high level tech ... and he's having a hard time duplicating.
Let me know ... and thanks.
No Ayman, that's not what is happening with in our office. It's a little bit more complicated than that. And, yes, I have already checked the settings, codes and such. There is not an issue with any of our settings.
We just had the issue creep up again at the end of our work day on Thursday. I ran the unsubmitted insurance claims and found for one of our younger patients, three of the four procedures got on one claim (#106759), and the other (four bitewings) did not get on "any" claim. That's the one that showed up as unsubmitted only.
For some reason, Softdent is not linking all those 4 procedures together. And, I know you're thinking it's because of the provider. But ... it's not because 2 of the 3 transaction items were from the same hygienist, or provider.
Sorry all! I have been viewing the comments and haven't replied in a timely manner! I haven't noticed it again but I think I know why it happened. I was changing the hygienist's provider ID BEFORE submitting to insurance. Ever since I started changing the ID after the appt is sent to insurance, it stopped. Thank you!
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