Corrections List Overview
On the Task tab in INSIGHT EMR, the Corrections List (available only to Total INSIGHT and INSIGHT clients) helps prioritize issues needing your attention and allows you determine which tasks to resolve first. Issues listed are linked so that you can go directly to the appropriate screen to fix the issue. If a signed visit has issues that appear on the Corrections List, then the visit charges for the visit cannot be created until the issues have been fixed. Most issues can be resolved in the Client Editor.
Important things to note about the Corrections List:
- Inactive patients and patients without an appointment or visit do not show up on the Corrections List.
- If an appointment is canceled, any associated issues that were displayed drop off.
- Patients with no active charges or active case do not display on the Corrections List.
- Insurance and referral expiration issues drop off after five days.
- If the Guarantor or Primary Payer Subscriber is different than the actual patient, then issues for missing Guarantor or Primary Payer Subscriber information will link to that different person but will reference the patient's name.
- Variable rate code type issues do not appear on the Corrections List. They appear on the Patient Issues List and are only included with Charge Issues if the patient has no other issues. If a patient has other issues, such as Case Admit Date Missing, those must be resolved first before Variable Rate Code Type will appear on the Charges with Issues list.
Corrections List fields
The Corrections List provides the following information to help prioritize issues needing your attention:
| Field | Description |
|---|---|
| Patient | Identifies the patient and issue on the patient's account that needs action. |
| Visit | Number of visits impacted by the issue. |
| Held $ | Financial impact the issue currently has on the clinic. |
| Age | Number of days the issue has been outstanding since sign off. |
Corrections List sections
The Corrections List is divided into the following sections:
Unsigned visits
The unsigned visit summary displays the number of unsigned customer visits for all therapists in all clinics in the database that remain unsigned for three or more days.
An unsigned visits prompt is displayed when a therapist accesses a patient in the Chart tab. This prompt lists the number of unsigned visits older than three days associated with the therapist logged into Total INSIGHT.
Corrections Queue
The Corrections Queue section identifies charge and demographic issues for patients with signed visits. The visit cannot be turned into billable charges until the issues have been addressed.
Demographic issues
Demographic issues are listed in the Corrections Queue in INSIGHT EMR and in the Patient Issues Listing in both INSIGHT EMR and INSIGHT Billing. Below is a list of issues that involve missing patient demographic information and how to fix them.
| 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 list. |
| 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 birthdate 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. |
Charge issues
Charge issues are listed in the Corrections Queue in INSIGHT EMR and in the Patient Issues Listing in both INSIGHT EMR and INSIGHT Billing. Below is a list of issues with charges on the claim and how to fix them.
| 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. |
Claims that need to be worked
Note: This feature is only available for Total INSIGHT customers.
In the Corrections Queue, INSIGHT lists many types of claims that need to be worked, generally because they have missing or incorrect information. This allows clients to correct claim issues that would result in automatic denial. The Change Log tab in INSIGHT records when an item is moved to the correction queue or released from it.
Denied claims with the following reason codes are displayed in the Corrections Queue:
| Denial Reason Code | Claim Type | Corrections Queue Message | How to Change Claim Status to Billable |
|---|---|---|---|
| 20, 22, 24, 32 | Any | Insurance states they are not responsible payer | Add a new payer to the payer mix, or add a new member ID, claim number, or case number. |
| 27, 200 | Any | Insurance coverage terminated | Add a new payer to the payer mix, or add a new member ID, claim number, or case number. |
| 31, MA27 | Any | Insurance unable to ID patient | Add a new payer to the payer mix, or add a new member ID, claim number, case number, or patient first or last name. |
| 109 | Medicare A or B | Payer needs to be updated to Medicare Replacement Plan | Add a new payer to the payer mix, or add a new member ID, claim number, case number, or patient first or last name. |
| 140 | Medicare A or B | Payer states full name and ID do not match their records | Add a new payer to the payer mix, or add a new member ID, claim number, case number, or patient first or last name. |
| 177 | Any | Eligibility Requirements Not Met by patient | Add a new payer to the payer mix, or add a new member ID, claim number, or case number. |
| MA36 | Any | Missing Incomplete or Invalid patient name | Add a new payer to the payer mix, or add a new member ID, claim number, case number, or patient first or last name. |
Appointments at Risk
The Appointments at Risk section identifies demographic, authorization, and referral issues for patients that have an appointment coming up in the next three days. The authorization and referral issues that appear are Insurance Authorization Date Expired, Insurance Authorization Visit Limit Reached, Referral Date Expired, or Referral Visit Limit Reached. Issues that appear in this section do not prevent charges from being created and do not appear on the Held Visits section.
