WebPT Ideas and Discovery

Antecedent: There are often times where we realize we input the wrong ID# into a patient's WebPT or we find that the carrier we added as primary is not the patient's primary insurance (ins). When that happens, we change their ins profile so that the correct ID# is listed or the correct carrier is listed as primary.

Resulting Problem: When an ID# or carrier is changed in WebPT, the new ID#/carrier flows into the patient's Therabill acct but the old/incorrect ID#/ins also stays. The problem is, when we go to Bulk Bill electronically, the claims often get billed out under the old/incorrect ID#/ins automatically, which leads to rejections & denials.

Idea: I am suggesting that when an ID# or ins is changed in WebPT, resulting in 2 primary ins profiles in the patient's Therabill acct, when we go to Bulk Bill or bill that patient's claims individually, their claims should be held back like Therabill does when there's no authorization, invalid zip codes, missing diagnosis pointers, & etc. Specifically, the presence of 2 primary ins profiles in a patient's Therabill acct should trigger their claims to be held back during Bulk Billing or billing for just that patient. That way, we will be prompted to update the patient's ins situation in Therabill by de-activating or deleting the old/incorrect ID# or carrier. Then, once there is only a single Primary ins profile in the patient's acct, Therabill can then allow the claims to be released.

Also: I know that sometimes a patient may be treating for 2 different cases (for ex., 1 body part is being treated under their Workers' Comp case & another body part is being treated thru their private ins). Their claims should still be held back during Billing though so we can make sure they're getting sent to the correct carrier. We have seen claims that were supposed to be billed to 1 case get sent to the wrong carrier automatically during the Billing process. If anything, we can just de-activate the Primary ins profile of the carrier the claims are not being billed to & then once we're finished we can go back in & re-activate the carrier since the patient does technically have 2 Primary carriers.