Potential Non-Critical Urgent
Claims Containing Charges with Insurance Balances Appear as Finalized
Release Date
May 10, 2019
Known Issue #
KI174924
Issue
In NextGen® Office Practice Management, claims that contain charges with insurance balances appear as Finalized. A claim's status should only be Finalized if the charge’s insurance balance = $0.00. The following workflows are affected:
- Claims Work List rules: Claims that should be flagged by unpaid rules will not be picked up. The user is therefore not triggered to track down unpaid balances.
- Following up on claims from Claims Status Dashboard: Unpaid claims appear under Finalized, which mean that they are paid. The user is therefore not triggered to track down unpaid balances.
Steps to Reproduce
- Create a claim.
- Apply an insurance payment so that insurance balance (Ins Bal) = $0.00.
Claim status is Finalized.
- Apply partial adjudication so that Ins Bal is greater than $0.00.
Claim is still in Finalized status. The status should revert to the prior status.
Action Required
To follow up on unpaid charges, use A/R Ledgers or Accounts Receivable reports. In Claims Work List, you must manually void payments/adjudication to undo the Finalized status.
Status
This issue was fixed on June 13, 2019.
Clients who are experiencing this issue can link their practice to this issue via the NextGen Healthcare Success Community homepage (https://www.community.nextgen.com). Just navigate to the Known Issues tab, select the Known Issue that is affecting your practice, and check the This Known Issue Affects me check box. A case will be created on your behalf and you will be kept updated on the status of this issue.
