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.

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

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 will be excluded from the report.

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

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.

• Filters by clinic assigned to procedure.
• If user is restricted to specific clinics, only accessible clinics will list. When checking All (includes hidden), results will include all clinics user has access to, including those marked hidden, and anything unassigned to a clinic; results do not include clinics user is restricted from.

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

Automatically Group Procedures: When checked, if selected procedures include same patient with different clinics or places of service, separate claims will be created for each clinic/place of service when clicking New Claims. When unchecked, users will be 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.

Refresh: Click 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.

• Patient Name: Last name and first name of patient associated to the unsent procedure. If Show PatNum: Aging, OutstandingIns, ProcsNotBilled is enabled in Report Setup: Misc Settings, also includes Patient Number.
• Stat: Procedure status.
  • C: Complete.
  • C/P: Complete (In Process).
  • Other procedure statuses (e.g., treatment planned) are not reflected in this list.
• Procedure Date: Date completed. See: Edit Procedure
• Procedure Description: Description from Edit Procedure Code.
• Clinic: Clinic assigned to the procedure (i.e., treating clinic).
• Amount: Patient billed fee. This may differ from the UCR fee, depending on insurance plan setup.

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 will indicate the number of claims that may be created. Click OK to proceed.
4. If there are any issues creating claims, an error will appear. Click OK to proceed. Claims without errors will still be created.

5. Another message will indicate the number of claims created. Click OK to close the message.

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