Duplicate claims

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drk
Posts: 155
Joined: Sat Oct 11, 2014 11:40 am
Location: Boston, MA

Duplicate claims

Post by drk » Wed Jan 21, 2015 10:19 pm

When you have a claim denied for being a duplicate (OA18), if you post it via RM, we have noticed that it credits the amount of the claim to the patient, and often they end up with a credit balance. How do you prevent this when you're posting a long ERA and there may be one or two duplicates embedded in the 835 somewhere?

Is there a report that you can run to weed out the duplicates so that the patient balance is accurate?

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Gavin Walker
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Re: Duplicate claims

Post by Gavin Walker » Thu Jan 22, 2015 8:59 am

No, but filing duplicates should be exception rather than the rule. I'll put in an enhancement request to have Revenue Management remittance posting check for duplicate claims.
Gavin Walker
Walker Tek Solutions, LLC
417-890-6777 x0
fax: 417-763-6386

drk
Posts: 155
Joined: Sat Oct 11, 2014 11:40 am
Location: Boston, MA

Re: Duplicate claims

Post by drk » Thu Jan 22, 2015 12:53 pm

While we are on the topic of enhancements, I would like to suggest the following on the Transaction Screen:

The claim line (top panel) should get highlighted whenever it corresponds to a transaction line (bottom panel). The functionality is "kinda sorta" there now. If you pick a posting line on the bottom screen and click on delete, the tiny black arrow on the claim line moves to the claim line that is affected. Now, this happens only after you click to Delete a Transaction. I am proposing that this highlighting be more prominent, and without having to click on delete (and then No) to figure out which claim line is targeted by this posting transaction. All necessary information is already there on the screen (and internally).

To summarize: When you select a claim/transaction the corresponding line(s) on the transaction/claim panel shall get highlighted. This would be a huge usability improvement, IMHO, as this will allow you to instantly recognize duplicate or missing claim lines/transactions.

Is there a more formal mechanism to suggest this to McKesson directly?

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Gavin Walker
Posts: 4625
Joined: Wed Apr 04, 2007 10:11 pm
Location: Springfield, MO
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Re: Duplicate claims

Post by Gavin Walker » Thu Jan 22, 2015 6:24 pm

No, there is no formal mechanism, but I will let them know.
Gavin Walker
Walker Tek Solutions, LLC
417-890-6777 x0
fax: 417-763-6386

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