An inactive procedure is a procedure which has been removed from a claim; the validation error (visible under Messages and Monitoring on a claim) means that there is a payment tied to that procedure. Until that payment is removed, the claim will not be able to be submitted or resubmitted.
Step-by-Step Instructions to Fix
- Find the claim in Billing Query, and open the claim.
- Right-click over any procedure and select 'Recovery' from the menu.
- In the window that opens, you will want to find the procedure that has a strike-through and also has a Yes in the Payments column. Select that procedure. Click Undo, then Save to close the window.
The recovered procedure code should now be visible on the claim. At the top of the claim screen, select History/Claim History.
- Right click and select Delete over the payment (and any adjustments) associated with that line item. (If the recovered procedure code is a duplicate of another procedure on the claim, you do have the option of removing the duplicate procedure and leaving the procedure with the payment instead.) On the next screen, click OK.
- Once the payment(s) has been removed, the procedure code can be deleted again, if appropriate.
If Recovery is not highlighted as an option from the right-click menu, please contact the iSalus Customer Success Team.