Troubleshoot Charges

This topic discusses things that can happen to a charge that is out of the ordinary and can delay your clinic's ability to post the charge and create a claim.

Issue What You Need to Do to Fix
CPT code used does not have a price set. Open the Fee Schedule Editor to add the CPT code to the fee schedule.
Incorrect modifier used, or modifier missing.

Open the Enter Charges window to manually change or add a modifier (such as 59, for a separate distinct procedure).

To add modifiers to Posted Charges for multiple dates of service at once, use the Apply Batch Modifiers tool.

Wrong fee schedule used. Open the Edit Payer window to check your payer settings. For example, a payer can categorized as workers comp on the Demographics tab of the Edit Payer window but is set as a commercial payer in the fee schedule.
Therapist has changed documentation Payer does not allow a specific CPT code to be used and the fee schedule doesn't say this CPT code isn't allowed.

Manually add the charge necessary and delete the original charge.

 

 

 

Claim being sent to payer includes multiple CPT codes, (some valid and some that need to be fixed).

Void the claim and manually add the charge that needs to be fixed and resubmit the claim.

 

 

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