Clearing up common error messages – Part 1

Published: Tuesday, 19 April 2022 13:47

As well as enabling you to send all your invoices from a single platform, Healthcode’s Clearing Service automatically checks each invoice meets the validation criteria set by the individual insurers so they are ready for payment on receipt.

While the vast majority of invoices are validated first time, occasionally you may see a section of the invoice highlighted and an error message. The purpose of error messages is to flag issues that would lead to the insurer rejecting the invoice so you can amend and resubmit it straight away, rather than discover a problem at a much later date.

To help keep your invoices flowing, part 1 of this mini-series is about the common error messages you may encounter in ePractice and what you can do to resolve them. Part 2 is for invoices raised on third-party software and submitted through VEDA.

1. Membership No: No matching membership details can be found

What this means:

The patient’s policy number is incorrectly formatted or doesn’t match the insurer’s database.

What you can do:

  • If you have a subscription to ePractice Lite or Pro, try Healthcode’s Membership Enquiry service to check the patient’s details against the insurer’s database.
  • Check with the patient or insurer that you have the correct details.

 

2. Membership No: Patient demographics do not match registration number

What this means:

The patient’s details – name and date of birth – don’t match those in the insurer’s database.

What you can do:

  • Check all names are spelled correctly and the date of birth is correct.
  • Check with the patient or insurer that there is no missing information e.g. the patient’s middle name. Healthcode are unable to disclose this information.

3. Procedure Code: Invalid Code

What this means:

The insurer does not accept this procedure code or the code format is invalid.

What you can do:

  • Always get pre-authorisation using the appropriate code for the treatment to be provided.
  • This email address is being protected from spambots. You need JavaScript enabled to view it. if you are struggling with rejected codes, pre-authorisations and other coding queries. We can explain what codes you can and can’t bill for and where necessary we can liaise directly with insurers to address problems and help ensure pre-authorised codes are accepted by the Clearing Service. 
  • If you are using Healthcode’s billing software and have undertaken a procedure you regularly perform, simply select it from the dropdown menu.

4. Specialist: Invalid Code

What this means:

This could be because you are not recognised by the insurer you are trying to invoice or there is an issue at Healthcode where you have not been added (mapped) to the list of people who can bill from that site.

What you can do:

  • If you have a PPR profile check the recognition status for the insurer - if you are listed as “pending” or “not recognised” you cannot send the invoice. If you think this is incorrect contact the insurer directly.
  • Contact Customer Services who can send a request to the insurer for the correct provider number, if necessary, or can arrange for you to be correctly mapped to the site.

5. Bill: Latest service date on bill exceeds maximum invoice age

What this means:

The invoice has not been submitted in time – the deadline varies by insurer.

What you need to do:

  • Contact the insurer directly to discuss the case.

 

If you need further help with invoice submission and validation, contact:

  • Harley the help bot which can answer queries outside office hours or get a member of the team to contact you. Click on the Harley icon on the bottom right of the Healthcode website to get started.
  • Customer Services who are available Monday to Friday from 08:00 to 18:00, excluding bank holidays, on 0330 900 4900 or email