Unprocessed Claim showing up in Remainder Statement

apna12 · Post by **apna12** » Wed Mar 23, 2022 7:38 am

Hi Gavin,

After updating to v24sp1, I've noticed remainder statements are generating for few claims. It's random and I can't figure out why medisoft is generating a remainder statement for claims that have not been processed. Any idea why this is happening and should I go back to V24?

Any help is appreciated.

Post by **Gavin Walker** » Tue Mar 29, 2022 8:31 am

There are many ways to make a charge non-insurance billable, but the most common issue I have seen is the insurance was setup on the case AFTER the charge was already entered.

The other issue I have seen is Cash Case was selected on the Case. This option basically tells Medisoft NOT to bill insurance. Make sure this check box is cleared.

Once you have verified the above is setup correct, then go into Transaction Entry and click Update All to resave the transactions under the insurance you have setup.

You should now be able to generate a claim.

apna12 · Post by **apna12** » Mon Apr 04, 2022 2:31 pm

Thanks Gavin,

There is no issue with generating a claim and sending it to the clearing house. This issue is with new patient unprocessed claims that are generating in Statements as a remainder. This happening for new patients and I did notice that all the new patients are not the primary insurance holders, they are under their spouse/parent.

The claims are setup the same for new or existing patients. For existing patients, we copy their last claim for visit and for new patients we create new claim using default setting. We add insurance and co-pay details only in the claim.

This is also not associated with any particular insurance company. I have tried running the medisoft utility and file index but now luck.

I may have to rebuild Medisoft....

Post by **Gavin Walker** » Tue Apr 05, 2022 7:23 am

What I suggested is on the Case record, not the insurance record. Fix it, then click Update All in Transaction Entry.

apna12 · Post by **apna12** » Thu Apr 07, 2022 7:08 am

Yes, I did "Update All" in the transaction entry after verifying the insurance. No change, appears to be a bug in Medisoft.

Post by **Gavin Walker** » Wed Apr 13, 2022 8:00 am

Try running the Billing Payment Status Report and see what that shows. There are many ways to flag a procedure so that it is not billable to a particular insurance.