Knowledgebase: Claims
Why are my charges not automatically transferring to the claim?
Posted by Claude Arnaud Lavaud on 28 Apr 2015 01:25 PM

Use the references below to help you identify why charges from an order do not carry over to the insurance claim:

1. Is there a procedure code on the item?

a. Verify the item has a procedure code attached from the respective Inventory Listing (File > Inventory > ***)

1. If a procedure code does not exist, add it to the item

a. Refresh the order by deleting and re-entering the item

2. Is the benefit eligible for the item on the order?

a. Verify the eligible benefits from the order using the "More" button

*Available benefits are: Frame, Lens, Exam, Contacts

1. If the benefit is not selected, confirm it is eligible and check the respective box

3. Does the insurance require an authorization?

a. From File > Setup > Insurance > Insurance Companies - Select the insurance and verify the option labeled "Insert Authorization from Order(Box 23)"

1. If Enabled, an authorization is required on the order to apply the benefits and process the insurance claim

*See Patient Profile > Insurance tab

a. Add the patient's authorization to the Profile and select it on the order

**Refresh the insurance claim to apply the changes**

If any changes are made from either of the options above, the insurance claim must be re-linked to the order:

1. Open the insurance claim and click on the "Link Order" button

a. Select the correct order to repopulate the charges 

**The claim can also be deleted from the Patient's Profile and regenerated from the order**

(Patient Profile - History Tab - Claims -- Select the claim and click on the "Delete" button)

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