SOS Technical Reference Document 
Copyright (c) 1996 by Synergistic
Office Solutions, Inc.


TOPIC..: Insurance Claims Do Not Print
REVISED: 01/26/96

SUMMARY
----------------------------------------------------------------
Among the reasons that a claim run might be unsuccessful are:

- No data match selection criteria
- Batch created but cannot be output


DIAGNOSIS
---------------------------------------------------------------
First try to determine whether the problem is in the selection of
data or printer output. Select "View HCFA 1500" on the menu of
output options. Carefully check the top line of the "Create new
batch?" window. Does the last batch correspond with your last
attempt to run claims? Does it show any claims in the batch? If
the batch has the correct number of claims, but none came out,
then the problem is on the output side rather than the selection
of data. Your claims are there, we just have to get them out.

If there are claims in the batch, continue with the output to
screen by selecting "No" for new batch. Do the claims display on
screen? If so, then the problem is with the printing system. Is
the printer on-line? If on a network, are you properly configured 
to use the desired network printer? Is there a print spooler or
print buffer that may be malfunctioning?

If there are claims in the batch but you cannot view or print
them, then the problem is almost surely that your OM program
directory is not included in your system's PATH statement
(normally set in the AUTOEXEC.BAT file) or that the OM
environment variable is set to the wrong directory or has not 
been set at all. If the latter is the case, then a tech document 
related to environment variables should display when you start OM.

If it turns out that no claims are printing because there are no
claims selected for the batch, then consider the possibilities
listed below:

- All items meeting the selection criteria have already been
marked as paid.
- Incorrect date range 
- All items have been marked as billed during a previous run
- Incorrect Carrier Category/Form Type selected 
- There were no items for the selected provider
- There were no patients matching the selected Patient Category
with pending claim items
- "Print Claim" at top of Policy screen 1 is set to "N"
- Ledger items are not flagged as insurance billable

CORRECTION
-------------------------------------------------------------
- Items already marked as paid. 
Items marked as paid will never print on an insurance form. If you 
really want to reprint them, you must remove the paid date. See the 
OM4 manual, pages 152 - 155.

- Incorrect date range
Check your date range to be sure you are using the correct dates. 
Sometimes people overlook a gross error in the year, for example. 
Most users will find that a three month range will be a good 
compromise between speed and picking up back entries and secondary 
carriers.

- Items already marked as billed 
Try changing the "Reprint previously billed items" option to "Y". You 
can also "unbill" all items with a specific billed date by using one 
of the utilities provided for you on the Other Tasks menu. To unmark 
specific items for a particular billed date, use ^U from the insurance 
output selection list.

- Incorrect Carrier Category/Form Type
The entry you make next to "Carrier Category" on your insurance run 
selection screen must match the Carrier Category entry on one or more 
of your Insurance Company screens.

- No items for the selected provider 
Unless there is a real reason to do so, do not enter a provider code 
in the selection box when you are generating insurance claims. Doing 
so forces OM to inspect every ledger charge to see if it was 
attributed to the selected provider. The extra step slows down the 
process of generating your claims. Leave this option blank for all 
providers.

- No items for the selected patient category 
Unless there is a real reason to do so, do not enter a patient 
category code in the selection box when you are generating insurance 
claims. Doing so restricts OM to those patients with matching 
categories. This can lead to skipped patients if categories have not 
been carefully set. Leave this option blank for all categories.

- "Print Claim" is set to "N"
The "Print Claim" setting is automatically reset to "N" if you 
configure a patient's insurance policy as a Medicare/EDI crossover. 
The crossover field should be set to "Y" only if the policy is a 
secondary that is forwarded automatically by Medicare or your claims
clearinghouse.

- Ledger items are not flagged as insurance billable
When you save a transaction OM checks the service code, provider, and 
fee to see if it qualifies for inclusion in insurance runs. If so, it 
sets a flag on this item. The insurance bill flag appears as an "I"
to the right of the posting date on the top line of the screen when
you inspect an item in the patient's ledger. If this flag is not set, 
the item will not be included in the claim run. Recalculating the 
ledger resets this flag. To recalc a single patient, display the 
patient's ledger by selecting View/Edit Ledgers on the PATIENTS menu
and press Ctrl-R. To recalc all patients, select Recalculate Balances
on the UTILTIES menu.


RELATED TOPICS

--------------------------------------------------------- 

See the OM 4 Manual, pages 176 - 178. 
See also documents:
"Insurance Form Type Mismatch" 
"Unpaying Insurance Charges"