Procedures Not Billed to Insurance Report

The Procedures Not Billed to Insurance report generates a list of procedures with an outstanding insurance estimate that haven't been attached to a claim.

In Standard Reports, in the Monthly section, click Procedures Not Billed to Ins.

Alternatively, in the Send Claims window, click Procs Not Billed.

All procedures on this list should either be billed to insurance or marked Do Not Bill to Ins in the Procedure Info window. Procedures only appear if the procedure has a fee and the patient has an active insurance plan.

This report can remain open while working in other windows.

To control user access to this report, see Report Setup: Security Permissions.

Filters

Select the report criteria, then click Refresh to update the list.

Show Procedures Completed Before Insurance Added: Check this box to include procedures that were completed before the patient's insurance was added. If unchecked, procedures set complete prior to insurance being added are excluded from the report. Procedure Codes marked Do not usually bill to Ins are still excluded.

From / To Dates: Defaults to today's date. Type a date or click the dropdown to and select a date to from the calendar. Click the arrow again or Refresh to close the calendar.

Clinics: Select clinics to include in the report. Ctrl + click to select multiple clinics or check All (includes hidden) to include all clinics, including those marked hidden.

Procedure Codes: Type procedure codes and choose a checkbox to filter out specific procedures.

Include Medical Procedures: Check to include unsent procedures for patients who have medical insurance. If unchecked, unsent procedures for insurance plans marked Medical are excluded.

Automatically Group Procedures: When checked, if selected procedures include same patient with different clinics or places of service, separate claims are created for each Clinic/place of service when clicking New Claims. When unchecked, users are blocked from creating claims when patient procedures have different clinic/place of service; users must select the procedures from the same clinic/place of service only to create claims.

Show Procedures in Progress: Check to view procedures with a status of Complete (In Process). These procedures must be Grouped for Multiple Visits.

Click Refresh to update report results after changing filter criteria.

Procedure Not Billed Grid

The report results list each procedure matching the filter criteria that is marked unsent. Descriptions of each column in the grid are below. Right-click a row and select Go To Account to open the selected patient's account.

Create Claims

To create claims from the Procedures Not Billed to Insurance Report:

  1. Highlight the procedures to create a claim for. Ctrl + click to select multiple procedures or click Select All to highlight all procedures in the list.
  2. Click New Claims.
  3. A message indicates the number of claims that may be created. Click OK to proceed.
  4. If there are any issues creating claims, an error appears. Click OK to proceed. Claims without errors are created.
  5. Another message indicates the number of claims created. Click OK to close the message.

Procedures that had claims created are now removed from the list and are Waiting to Send. Any unselected procedures or those with errors, remain in the list.

Send claims from patient accounts or the Send Claims window.

Print Report

Click Print to launch a print preview of the report results. For a description of toolbar buttons, see Complex Report System. The data columns on the print preview are the same as the report grid listed above.