Why are the claim approved units not matching units sent? (FAQ)

Solution:

There are instances where a bill code is linked to visits, then the bill code was disabled but a replacement bill code was not added to the service code prior to claim generation. This results in mismatched units.

The steps below will help you find the bill code and resolve this issue:

• Navigate to Accounting > Accounting Settings > Bill Codes.
• Change status filter to 'Disabled'.

• Filter for this bill code, you should see this bill code is listed in the Disabled listing.
  • • If this bill code is not disabled, please create a Zendesk ticket for our support agents to investigate.
    • If this bill code is disabled, please continue with the steps below.
• You will need to change the code name and description of the bill code to put DNU in front of the description (this is to allow you to easily identify if this bill code is attached to the service code and visit).

• From there, navigate to Service Codes and search for the service code linked to the visit.
• Use the drop-down arrow next to the Edit button and choose 'Edit billing detail'.

• You should see this bill code with DNU as the precursor, this bill code needs to be replaced with the correct enabled bill code by clicking on the Edit button for that payor in the service code and change the bill code to the correct one.

• Click on the Confirm button then the Save button to save the change.
• Navigate to the affected claim(s) and void them, generate claims again as per your normal practice in order to pick up the replacement bill code.

Notes:

• You can troubleshoot the issues explored in this article in your staging environment.
• If the issue is not resolved after going through the steps in this article, please search through other related Zendesk articles or have your super user submit a Zendesk ticket.
• For a full list of FAQs related to Claims, check out this section in Zendesk.