Reason for Message: The procedure tied to the appointment is marked as an action item.

This setting can be changed when editing a procedure in list maintenance, see screen shot above.

Reason for Message: The procedure tied to the appointment is not marked as an action item but the proper trigger has been met to process this non-action item.

Reason for Message: There is an activity tied to the appointment.

Reason for Message: An authorization record is required to process the appointment and an appropriate authorization record was found.

The authorizations for a contact are usually located on the Insurance Information form(Fiscal Department) they have that corresponds to the insurance company paying for the service.

Reason for Message: There is a contact/client/customer/patient tied to the appointment.

Reason for Message: The appointment is associated with a particular system department.

Reason for Message: A diagnosis was required for the appointment and a Axis I diagnosis was successfully found.

The need for a diagnosis is determined by the organization's Billing Scheme, if you need to know your Billing Scheme please contact Unicentric.

Reason for Message: A diagnosis was required for the appointment and a Axis II diagnosis was successfully found.

The need for a diagnosis is determined by the organization's Billing Scheme, if you need to know your Billing Scheme please contact Unicentric.

Reason for Message: There is a user tied to the appointment.

This message will most likely appear 100% of the time as in almost all manners of inserting appointment data a user must be selected.

Reason for Message: There is a location tied to the appointment.

Reason for Message - There is an activity modifier tied to the appointment.

Usually this is associated with the user degree or credentials, this modifier often changes the amount being charged for the service.

Reason for Message - An insurance information form was found that corresponds to the insurance company paying for the service. On this insurance information form the "Authorization Required?" drop down is set to "No".

Reason for Message - There is a program/cost center tied to the appointment.

Reason for Message - An insurance rate was found that corresponds to the procedure/payer/date of service being used for the appointment.

Reason for Message - A procedure was found with the mapping to fit the details of the appointment record. This procedure must also be active and billable.

The procedure mappings can be found at the bottom of the screen when editing a procedure, a screen shot of this section is below.

Reason for Message - There was an issue when trying to determine the authorization, please consult Unicentric for further information.

This message can appear for a magnitude of reasons, if the issue can't be resolved create a feedback detailing the problem.

How to Resolve - Contact Unicentric for further details.

Reason for Message - This message will appear for 1 of 2 reasons.

1. The contact tied to the appointment doesn't have a Billing Schedule
2. The contact tied to the appointment has a Billing Schedule with no insurance companies attached and "No Insurance" checkbox is unchecked.

How to Resolve -

1. Create a BIlling Schedule and add an insurance company. OR
2. Create a BIlling Schedule and check the "No Insurance" .

Reason for Message - An Insurance Info. form for the contact was found but no insurance company is selected.

How to Resolve - Select an insurance company on the contact's Insurance info. form.

Reason for Message - The appointment doesn't have a program associated to it.

Reason for Message - The appointment doesn't have a location associated to it.

Reason for Message - The appointment doesn't have an activity modifier associated to it. The activity modifier corresponds to the degree/credentials of the user whom performed the service.

How to Resolve - If there is no activity modifier but there should be, check the Employee form of the user whom provided the service. On this form check to make sure the degree/credential field has a value selected, if it is correct but still not pulling to the item then contact Unicentric for further assistance.

Reason for Message - An authorization was required for the appointment but the system was unsuccessful in finding an appropriate authorization.

How to Resolve - If you know there is an authorization for this contact/service then check the Insurance Info for the contact. Make sure there is a row in the authorization grid that has:

1. Date Range that includes the Date of Service
2. Is for the CPT Code that matches the CPT Code of the appointment.
3. Has remaining units available

If a row exist with those criteria but the warning still appears, contact Unicentric for further assistance.

Reason for Message - The insurance company attached to the appointment doesn't have a batching scheme selected.

How to Resolve - Set a batching scheme for the insurance company in List Maintenance, screen shot of the field below.

Reason for Message - This message will appear with the name of a custom script that was created for the organization.

How to Resolve - Contact Unicentric along with the details of the appointment it appeared on, this is something we will have to resolve internally.

Reason for Message - There are two conditions that must be met for this message to appear:

1. Another appointment released to the proofing screen exist with the same Contact, Procedure, and Date.
2. The consolidation rules for the procedure being used are set to none

How to Resolve - Resolving this issue is only required if the consolidation rules for the procedure are incorrect or you're not allowed to bill for this same procedure more than once on the same day. Usually if a procedure is not to be billed more than once a day the second appointment will be rejected by the insurance company.

Reason for Message - A valid Insurance Info. form has been found but the copay field is empty.

How to Resolve - Go to the Insurance Info. form in the contact's record and update the copay field. If there is no copay set the value to 0.

*NOTE* - If Auto Process is checked for this appointment this message will appear as a warning(Yellow).

Reason for Message - The insurance company tied to the appointment is not in the system.

How to Resolve - Verify the insurance company being used is in List Maintenance -> Payment Sources, if its present then contact Unicentric for further assistance.

*NOTE* - If Auto Process is checked for this appointment this message will appear as a warning(Yellow).

Reason for Message - Appointment being processed has already been billed to the insurance company currently on the item.

How to Resolve - Ensure that the appointment shouldn't be billed to another insurance company for the contact such as a secondary payer. If this is not the case, its possible that the item was previously billed by mistake, for any unresolvable issues, contact Unicentric.

*NOTE* - If Auto Process is checked for this appointment this message will appear as a warning(Yellow).

Reason for Message - Appointment being processed has already been billed to the insurance company currently on the item and that payment was declined.

How to Resolve - This may require some investigation as you will have to know why the payment was declined to assess if there is an issue. The reason for decline will not be available in Unicentric and would have to be viewed on a site hosted by the clearing house being used, most likely Emdeon. If you need credentials to login to Emdeon's site or need help resolving these issues please contact Unicentric.

*NOTE* - If Auto Process is checked for this appointment this message will appear as a warning(Yellow).

Reason for Message - The appointment's date of service doesn't fall into the date range of the insurance plan coverage, these dates are available on the contact's Insurance Info. form.

How to Resolve - This depends on if the Insurance Info form information is correct, if the start or end date is incorrect you might be able to fix it by updating either. If this is not the case then a new insurance plan must be added, a different insurance company must be used or the item will default to self-pay.

*NOTE* - If Auto Process is checked for this appointment this message will appear as a warning(Yellow).

Reason for Message - The Insurance Info. form tied to the insurance company has the "Inactive" checkbox checked.

How to Resolve - If this is incorrect then go to the contact's Insurance Info. form and uncheck the "Inactive" checkbox.

*NOTE* - If Auto Process is checked for this appointment this message will appear as a warning(Yellow).

Reason for Message - This message will appear if there is an error while evaluating a rate, whether it be for third party or self-pay. It is not tied to any one issues so if it appears contact Unicentric for further details.

Reason for Message - The appointment doesn't have a contact tied to it.

Reason for Message - The appointment doesn't have a user tied to it.

Reason for Message - The appointment doesn't have an activity tied to it.

Reason for Message - Your organization doesn't have a Billing Scheme, the Billing Scheme of an organization determines how some things in billing are handled.

How to Resolve - This is a very rare issue, if it does occur contact Unicentric.

Reason for Message - The insurance rate being used has the "Unit Per Hour" value  set to 0 when using a Calc Method based on Units.

How to Resolve - The insurance rate "Unit Per Hour" value must be updated in List Maintenance -> Payment Sources -> Edit Payment Source Being Used -> Edit Insurance Rate Being Used(Edit Insurance Rate dialog in screenshot below).

Reason for Message - A diagnosis for client is required based on the organization's billing scheme but one wasn't found.

How to Resolve - If the contact should have a diagnosis and doesn't you will have to add this to their Diagnosis form. If a diagnosis shouldn't be required then contact Unicentric for further assistance, could be an issue with your billing scheme.

Reason for Message - A valid Insurance Info. form was found but the Policy # of their plan isn't filled out.

*NOTE* - If Auto Process is checked for this appointment this message will appear as a warning(Yellow).

Reason for Message - A procedure can't be identified based on the appointment details(program/activity/location/modifiers/expense/diagnosis type).

How to Resolve - To resolve this you must know what procedure you want it to use then you can figure out where in the mapping there are possible issues. One tool that can help is a button called "Test Mapping" in List Maintenance -> Procedure -> Edit Procedure you wish to use. It will show you all the combinations of appointment details that will map to that procedure(Screenshot below). At the creation time of this article Test Mapping is only available in Classic view.

*NOTE* - If there is no contact attached to the appointment then the item will turn gray.

Reason for Message - An insurance rate couldn't be found for the particular Insurance Company/Procedure/Date of Service being used.

How to Resolve - If an insurance rate should exist then it must be added under the payment source being used. This can be done by going to List Maintenance -> Payment Sources -> Edit the Payment Source being used, at the very bottom of this dialog in the rates tab you will see an "Add" button, pressing this will make a dialog appear so you can enter the details for the new rate. WARNING - To do this you must understand the properties of the rate you want to setup, if you need assistance contact Unicentric.

*NOTE#1* - Some payers have their insurance rates underneath another "Master" payer. To know if this is the case edit the insurance company being used(List Maintenance -> Payment Sources), look at the "Waterfall CPT codes from payer" field. If this field has another insurance company selected then all rates for the insurance company you're editing will be under the other insurance company in the "Waterfall CPT codes from payer"  field. If this field doesn't have another insurance company selected then all rates will be under the insurance company being edited.

*NOTE#2* - If Auto Process is checked for this appointment this message will appear as a warning(Yellow).

Reason for Message - The payer for the appointment is set to "Self-Pay" but there is no self-pay rate entered for the procedure.

How to Resolve - This is probably one of two issues:

1. The item didn't correctly link to the intended third party payer thus defaulted to self-pay. In this case you have to resolve why the item didn't link to the insurance company.
2. The item should be for self-pay but there is no self-pay rate for the procedure. In this case you must enter a self-pay rate for the procedure, this can be done under List Maintenance -> Procedure -> Edit the procedure being used. At the bottom of this screen are a series of tabs, click the second one for Self-Pay Rates, in this tab you can add/edit the rate.

Reason for Message - The procedure being used for the appointment has the "Is Active" checkbox unchecked.

How to Resolve - If this procedure should be active then the "Is Active" checkbox must be checked under List Maintenance -> Procedures -> Edit procedure being used.

Reason for Message - The procedure being used for the appointment doesn't allow third party payers but one is associated.

How to Resolve - If this procedure should allow third party payers then the "Allow Third Party" checkbox must be checked under List Maintenance -> Procedures -> Edit procedure being used.

Reason for Message - An error has occurred when trying to determine the charge of the appointment.

How to Resolve - There are many reasons why this message can appear, for further instructions contact Unicentric.

*NOTE* - When this message appears the charge will default to $0.

Reason for Message - An error has occurred when trying to determine the client's liability for the appointment.

How to Resolve - The first thing to check is to see if the client has an Insurance Company set up on their billing schedule. If they do not and that is expected, check the  "Overide Agency Billing" grid that is on the Billing Schedule form. There should be an entry for the Activity in the service.

If the "Overide Agency Billing" grid has an empty row, use the delete button to remove that row. This will cause issues when determining the correct charge to the client.

*NOTE* - When this message appears the client liability will default to $0.

Reason for Message - The insurance company tied to the appointment has only non-billable insurances rates for the procedure being used.

How to Resolve - If the procedure must be billable to the insurance company then a billable insurance rate must be added. This can be added in List Maintenance -> Payment Sources -> Edit Payment Source being used -> Press Add button in Rates tab.

Reason for Message - The procedure tied to the appointment has only non-billable self-pay rates.

How to Resolve - If Self-Pay should be billable then a billable self-pay rate must be added. This can be added in List Maintenance -> Procedures -> Edit Procedure being used -> Self Pay Rate tab.

Reason for Message - The procedure tied to the appointment has the "Billable" checkbox unchecked.

How to Resolve - If the procedure should be billable then you must check the "Billable" checkbox in the procedure settings. This can be done in LIst Maintenance -< Procedure -> Edit Procedure being used -> Billable checkbox.

Reason for Message - This message appears when the "Auto" checkbox is checked for the appointment(visible on proofing screen). Some of the exceptions messages are turned to warnings when this is checked.

Reason for Message - This message appears when a diagnosis is not required to process an appointment. This setting is based on the billing scheme of the organization.

Reason for Message - An expense is attached to the appointment.

Reason for Message - This message appears when the "Auto" checkbox is unchecked for the appointment(visible on proofing screen).

Reason for Message - This message appears when there is no expense attached to the appointment.

Reason for Message - There is no department attached to the appointment.

Reason for Message - There is an insurance company attached to the appointment but the procedure doesn't allow for third party payers.

Reason for Message - An insurance company couldn't be found for the appointment, the payer will default to self-pay.