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Duplicate claims

Posted: Wed Jan 21, 2015 10:19 pm
by drk
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?

Re: Duplicate claims

Posted: Thu Jan 22, 2015 8:59 am
by Gavin Walker
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.

Re: Duplicate claims

Posted: Thu Jan 22, 2015 12:53 pm
by drk
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?

Re: Duplicate claims

Posted: Thu Jan 22, 2015 6:24 pm
by Gavin Walker
No, there is no formal mechanism, but I will let them know.