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.