Running Error Check Validation
Complete this task to run the Error Check validation for either a charge batch or a case in a charge batch.
Cases in the charge batch are validated for errors or warnings. Errors affect claims generation and must be corrected before a claim can be created. Warnings may cause a claim to be rejected by a payer, but do not have to be corrected before a claim can be created.
The error check process automatically validates the following conditions:
Category | Description |
|---|---|
Concurrency | An exception that occurs when one or more cases have anesthesia provider time violations. This exception can be detected across multiple cases. In most cases, concurrency exceptions are reported as errors unless concurrency validation is excluded on the case. If concurrency is excluded on the case, exceptions are reported as warnings. Concurrency checking is excluded on a case with service fee lines that have been rebilled without changes to fees. |
CCI | A code auditing exception that occurs when there are discrepancies between the diagnosis code and the procedure code. CCI edit warnings are not required to be resolved before submitting a charge batch, but if not corrected the problems may result in claim rejections by the payer. |
ICD-9 / ICD-10 | An exception that occurs when a diagnosis code is inappropriate on a case. For example, the diagnosis code does not match the age or sex of the patient. ICD-9 edit warnings are not required to be resolved before submitting a charge batch, but if not corrected, the problems may result in a claim rejection by the payer. |
Payer | An exception that occurs when there are discrepancies between a claim and the claim filing rules of the specific payer or plan, for example, missing provider identification numbers, or date of service of procedure occurs after provider effective date. |
Data | An exception that occurs when any primary data element (for example, primary diagnosis code) is missing, is required on the case, or is required based on specific conditions within a case. This exception can be detected across multiple cases. Required data must be entered before a claim can be created. |
If errors are detected, you must correct them before submitting the charge batch.
Step-By-Step Guide
Error Check Validation for Charge Batch
Instructions | Additional Information | |
|---|---|---|
| 1 | From the Charge Batches / Batches tab, select the charge batch to validate, OR From the Charge Batch / Charge Batch Information page of the charge batch being validated, Click Error Check (or press [Alt] + K). The Error Check Validation process begins. This process validates all cases in the charge batch. | When the process completes, the Charge Batch Error Check tab appears on the Charge Batch: [ID] page showing any specific case errors or warnings. Multiple batches can be selected for an error check from the Charge Batches / Batches tab by holding the CTRL key and selecting the necessary charge batches. |
| 2 | Click Yes to the confirmation message. | If only one batch is error checked, the Charge Batch / Charge Batch Error Check tab is opened following the error check to correct errors. If multiple batches are error checked, the batches are not opened in separate tabs following the error check and must be searched and updated individually. |
| 3 | Use the following tasks to manage errors and warnings that were detected through the Error Check validation process: |
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Error Check Validation for a Case
You cannot run the Error Check validation unless the case has been saved.
Instructions | Additional Information | |
|---|---|---|
| 1 | From the Charge Batches / Batches tab, select the charge batch to validate, |
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| 2 | Click Update (or press [Alt] + U). The Charge Batch / Charge Batch Information tab opens. |
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| 3 | Click the Charge Batch Error Check tab. |
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| 4 | Find the case to validate by using the Case ID and Display filters. |
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| 5 | Click Error Check (or press [Alt] + K). The Error Check Validation process begins. This process validates the specified case only. | When the process completes, any errors or warnings that were detected are listed in the Error Check table. |
| 6 | Use the following tasks to manage errors and warnings that were detected through the Error Check validation process: |
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Charge Batches / Case Holds Tab
Charge Batches / EDC Files Tab
Charge Batches / Eligibility Tab
Charge Batch / Charge Batch Information Tab
Charge Batch / Charge Batch Error Check Tab
Charge Batch / Concurrency Log Tab
Charge Batch / Image Batches Tab
Case / Patient, Guarantor & Insurance Tab
Case / General Case Information Tab
Case / Procedures & Provider Time Tab
Case / Additional Case Information Tab
Correcting Errors and Warnings
Not applicable for this topic