Run Patient Issue Listing

What is the Patient Issue Listing?

The Patient Issue Listing is a tool that displays a list of patients with issues that need to be fixed before the charges can be posted to the system in order to create a claim. The system has been designed with validations in place that help your clinic address issues before claims go out the door, resulting in faster payments for your clinic. Front desk and billing staff should run the patient issue listing daily to correct errors that can delay the billing process. Inactive patients with no charges are not included in the Patient Issue Listing. If an appointment is canceled, any associated issues that were displayed drop off.

Charges in this report have issues that need to be corrected before posting the charge and creating a claim. These charges typically have a demographic or charge issue(s) that needs to be corrected before you can post the charge. To reduce the number of charges that enter Billing with issues, make sure your clinic has correctly entered all the necessary patient information in the Client Editor. To reduce the number of charge issues, review your clinic's payer setups, and fee schedules. The Demo and Chg column displays the number of issues that need to be fixed. Demo issues are related to the patient's demographic information (typically handled by front desk staff) and Chg issues are related to the fee schedule or payer settings (typically handled by billing staff). Clicking the red X icon automatically opens the editor that is required to view and correct the issue. Once all of the issues have been fixed, the charge is automatically sent to the appropriate category below and the red X icon turns into a green edit (or ready) icon.

How often should I run it?

Clinicient recommends that management review the patient issue listing at least weekly to address persistent issues that impact cash flow.

Can I update the information that displays on the list?

Use the Refresh button to update information on the screen. There are three options when using the Refresh button:

  • Re-Create All Issues checks for validation issues for all charges that are currently unposted.
  • Verify Charge Issues re-checks all charge issues and removes charge issues that are no longer an issue.
  • Verify Patient Issues re-checks the Issues column and removes all patient issues that have been fixed.

Use the steps below to run the Patient Issue Listing.

  1. Log in to Insight.
  2. From the Run menu, select Patient with Issues. Patients with missing information, such as demographic information, missing Plans of Care, and/or missing fee schedules are listed. You can easily filter the list by dragging a column to the gray bar at the top of the list. For example, to see the list by issue type, drag the Issues column to the gray bar at the top of the list. Use the drop-down arrow to see the list of all patients with a specific issue type.
  3. Double click a row to go directly to the specific editor that fixes the selected patient's issue. You will see a red breaking bar at the bottom of the window that opens. This explains the issue that needs to be corrected.
  4. If the Issues column and Charge Issues column show missing information, when you double click on the row, the editor will attempt to fix the Issues column first. Once the Issues column has been resolved, you can double click the row again to fix the charge issue. Medicare patients with missing Plan of Care dates are listed in the Charge Issues column.

Tip: Use the Task button at the bottom of the list to create and assign a task for anyone in the clinic who needs to provide information for the patient.

Charge Issues

Charge Issues Column What You Need to Do to Fix
No Units Count or Time specified. Enter the number or units used or time in the Enter Charges window.
No Caregiver specified. Select the person who performed the care or procedure.
No Fee Schedule specified. Set the fee schedule to use in the Edit Payer window on the Fee Schedule tab. If needed, add a new fee schedule.
No Expected Reimbursement Schedule specified. Set the expected reimbursement schedule in the Edit Payer window on the Fee Schedule tab.
This code [#####] is not on the [FeeScheduleName] Fee Schedule.

Add the specific charge to the fee schedule listed.

 

Variable rate code type. Charge amount must be entered manually.

 

 

 

Manually enter the charge and add a short description of the charge in the Enter Charges window. Use variable rate codes for supplies such as splinting, tape, grippers, etc. when submitting claims to a workers comp payer. Note: If a patient has other issues, e.g., Case Admit Date Missing, those must be resolved first before Variable Rate Code Type will appear on the Charges with Issues list.
No Plan of Care for date of service m/d/yyyy Select a Plan of Care on the Case Information tab in the Client Editor for the service date specified.

Demographic Issues

Issues Column Message What You Need to Do to Fix

Client ID missing.

 

Enter the patient's insurance ID number on the Case Information tab in the Client Editor.

Client signature date missing.

 

Select a signature date on the Case Information tab in the Client Editor. Make sure the client has signed the appropriate intake forms.
Facility ID missing. Select a facility on the Case Information tab in the Client Editor.
Responsible Caregiver missing. Select a Supervisor on the Case Information tab in the Client Editor.
Discipline code missing. Select a discipline on the Case Information tab in the Client Editor.
Case admit date missing. Select an admit date on the Case Information tab in the Client Editor.
Case onset date missing. Select an onset date on the Case Information tab in the Client Editor.
State of Auto Accident missing. Select the state the auto accident occurred in on the Case Information tab in the Client Editor. This field is only required if accident type is Auto.
Referring Physician missing. Select a referring MD on the Case Information tab in the Client Editor.
Medicare Secondary Payer Reason Code must be selected when Medicare is Secondary. Select the reason Medicare is the second payer. Note: This message only displays if Medicare has been selected as the second payer in the Case Information tab in the Client Editor.
No primary diagnosis code. Add a diagnosis on the Case Information tab in the Client Editor.
No version specified for primary diagnosis. Add a diagnosis on the Case Information tab in the Client Editor.
No relationship specified for Primary, Secondary, or Tertiary Insurance Plan. Select the patient's relationship to the subscriber on the Case Information tab in the Client Editor.
No Primary, Secondary, or Tertiary Insurance Plan specified. Select the patient's insurance plan from the Plan Name drop-down box.
No subscriber for Primary, Secondary, or Tertiary Insurance Plan. Select the insurance plan subscriber on the Case Information tab in the Client Editor.
Primary, Secondary, Tertiary Insurance Member ID, Policy ID and Claim Number are all blank. Enter the Member ID, Policy ID, or Claim Number on the Case Information tab in the Client Editor.
Clients/Subscriber must have a last name. Enter the patient's last name on the Personal Information tab in the Client Editor.
Clients/Subscriber must have a first name. Enter the patient's first name on the Personal Information tab in the Client Editor.
Clients/Subscriber must have their gender specified. Select the patient's gender on the Personal Information tab in the Client Editor.
Clients/Subscriber must have their birth date specified. Select the patient's date of birth on the Personal Information tab in the Client Editor.
Clients/Subscriber must have their address specified. Enter the patient's address in the Addr Line 1 field on the Personal Information tab in the Client Editor.
Clients/Subscriber must have their city specified. Enter the name of the city the patient lives in on the Personal Information tab in the Client Editor.
Clients/Subscriber must have their state specified. Select the state the patient lives in on the Personal Information tab in the Client Editor.
Clients/Subscriber must have their zip code specified. Enter the patient's zip code on the Personal Information tab in the Client Editor.

Create Tasks from Patient Issue Listing

You can create tasks directly from the Patient Issue Listing.

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