Scrubbing Report Errors (K)
Note: When adjusting a Payer's HCFA settings please be aware of Settings for level (Primary, Secondary or Tertiary), the Form type (08/05 or 02/12), and 1500 Output Option(Paper or Electronic).
Within Admin>Payers>Select Payer>Edit:
This is where you would go to select the information on the HCFA that should display within each box.
Printing Options Tab
This is where you would go to check which boxes are selected to Print. NOTE: Boxes displayed as Yellow is what will be printed. Boxes displayed as White is what will NOT be printed. To select the individual Boxes TO Print(Yellow) or NOT to Print(White), Just click on the Box.
Here are some possible Scrubbing Report Errors you may come across and how to fix them:
Box 4: Box 4 not displaying insured's name
FIX: If Box 4 is displaying the insured's name(this will either be the patient's name, another patient's name or a non-patient's name)but passing scrubbing and not printing. If and once the correct data is entered, please go to Admin>Payers>Select the Payer>Edit>Printing Options>Select Primary, Secondary or Tiertiary>and switch Box 4 from leave blank to print ALL patient information>Save
Box 5: Patient Phone [Patient File>Patient Tab]
FIX: Add the phone number in under patient tab in the patient file. If patient does not have a home phone number, please add their cell phone number in the Box 5 area
FIX: Enter patients file, insurance tab, select policy, Edit and add the necessary info into the box 11 area. Then go to Admin, Payers, Select the Exact Payer connected to the patients charges, edit, select printing options tab, go down to box 11 and make sure it states to "Print information from patients policy" then SAVE.
Box 11d: Another Health Plan Benefit [patient file>insurance>policy]
FIX: Enter patients file, Insurance tab, select policy, Edit and if the patient has a secondary, you will select YES, if not, You will select NO.
Box 13: Patient authorization of benefits signature [patient file>insurance>policy]
FIX: Enter patients file, Insurance tab, select policy, Edit, and you need to make sure the Box 13 is checked, indicating Patient Authorization of Benefits has been completed by the patient
Box 14: Date of current illness/injury [Patient Appointment>Edit ICD]
FIX: This is located within a patients file, Appointment tab, Select Appointment, Select Review button, under Edit ICD panel, find injury onset date, enter the appropriate information then Check out the appointment
Box 15: same/Similar date [patient appointment->Edit ICD]
FIX: If box 15 IS NOT a requirement for billing. You can go to Admin, Payers, Select the payer, Edit, Select Primary, Secondary or Tiertary, Scrubbing tab and make sure that box 15 is not highlighted as a requirement and save. If Box 15 IS a requirement for billing, you will go to the patients file, review their appointment, Edit ICD area, Box 15 and add in the necessary info, then check out the appointment. Then go to Admin, Payers, Select the payer, Edit, Select Primary, Secondary or Tiertary, Scrubbing tab and make sure Box 15 is highlighted (this indicates this box will print)
Box 17b: Referring Provider npi [Admin>Billing Entities]
FIX: Admin, Payers, Select payer, Edit, printing options tab, go down to box 17B, click the box and select the NPI option for the claim to have the NPI printed and save. **If you do NOT have a referring provider, go to that payer, then change what will print to show billing provider instead of referring provider and save**
Box 19: [patient appointment>ICD]
FIX: If you are wanting info to print in box 19, you will have to go to the patients file, appointment tab, select appointment, review, go to Edit ICD panel, go down to box 19, add info in and check out the appointment again to save data. Then go to Admin, Payers, select payer this is coming up for, Edit, Select scrubbing tab, go down to box 19. For it to Print, it will need to be highlighted(Yellow), Save and then try to generate the claim again.
Box 21: Diagnosis and Diagnosis Pointer [edit charges>edit codes]
FIX: Go to Admin: payer, Select primary or secondary (this will be determined by what the payer is listed in the patient's insurance snapshot), go to to printing options, in box 21: change 9 to 10, SAVE First. Then check to see if the Error still occurs on the scrubbing report. If it does:
Then go to the patient file>appointments>select the appt>Review> In edit charges you will scroll to the right to the column that says ICD's> Click the box and make sure that ICD's are correctly checked and SAVE. Then check out the appt and run it to see if any other errors
Box 24a: ToDate of Service (To) [Patient Appointment-> Edit Charges]
FIX: Admin, Payers, Select the payer, Edit the payer, Go to the printing options tab, go down to box 24 and in the first drop down change info selected to "To and From" and then save. Is this the patient's primary, secondary or tiertiary? Depending upon your answer, you will need to select primary, secondary or tiertiary once you select printing options. Within Printing Options, Box 24 you will see "From & To" with options of: 6 digits or 8 digits. If you don't know which one to choose, because certain payers take one or the other, First select 6 digits "From & To" and if it doesn't pass scrubbing after you make that switch, switch it to 8 digits.
Then make sure Form 02/12 is selected, Move to Scrubbing Tab and make sure Box 24 is Yellow(Selected to Print) and SAVE.
Box 27: Accept Assignment [patient file>insurance>policy]
FIX: Enter patient file>Insurance Tab>Select Insurance>Edit>make sure box 27 indicates YES. This is saying that you(the clinic) is accepting this patient for Care.
FIX: To have money amounts placed into box 29, you will have to go to Admin, Payers, select the medicare payer in question, Edit, select the printing options tab, go down to box 29 and select what is needed to show from the dropdown and save
Box 32:Facility Name/Address [Patient 's Appointment]Edit charges or Admin->Billing Entities
Box 32a: Facility npi [patient's appointment>Edit charges or Admin > Billing Entities
FIX: To change the information that is generated in box 32 & 32a you will need to go to Admin > Payers > Select the correct insurance company > Edit button on bottom > Printing Options tab > Select either 'Primary' or 'Secondary' at top left of screen > Scroll down to box 32 and select drop down > From there you can choose which information should populate for that box. Then go to the Scrubbing Tab, down to Box 32 & 32a to make sure they are yellow. The boxes in Yellow are what are to print on the HCFA's
Information on Forms/Boxes:
NOTE: Form 02/12 became effective as of April 1st, 2014 replacing Form 08/05