Billing Report Warnings and Errors (Pre-Transmission)

Charges on the Billing Report undergo several validations to ensure that the billable items meet certain requirements. The goal of these alerts is to help prevent claim rejection and/or denials that can occur when billing an incomplete charge.

There are two types of alerts: 

• Red: Error state. You cannot bill the charge until the error is resolved. These errors must be resolved before the claim can be transmitted or grouped. When an error is resolved, it can take 5 to 15 minutes for the error to be removed from the billing audit tool report by the system.    
  

• Yellow: Warning state. You can bill without resolving the warning. These warnings do not need to be resolved before the claim can be transmitted, grouped, or marked as Do Not Bill.   
  
• Both: You can also encounter both Red and Yellow together. In this instance, you must resolve the Red before billing and determine if the yellow needs to be resolved.
  
• Important: Some of the alerts allow modifications to the type. For example, if you would prefer to prevent charges from being billed when the date of service is before the admission date, you can change that alert from a warning (yellow) to an error state (red). Click here for instructions.  

Warnings and errors can be configured in Settings > Billing Audit Tool > Warnings and Errors. From here, you can choose to keep them as alerts, elevate them to errors, or disable them entirely depending on workflow needs.

Post-Transmission Errors

The errors and warnings described in this article appear on the billing audit tool report before the charges are transmitted. For a list of errors that can occur after the attempted transmission from the billing audit tool report, check out the related article by billing integration: CollaborateMD | Kipu RCM.  

Error/Warning and Resolution

Important: When an item is fixed, it can take 5 to 15 minutes for the error to be removed from the billing audit tool report by the system. If you make corrections to a template, you will need to re-add the template, as the changes made there will only apply automatically going forward.    

Error Message	Solution	Type
Authorization is outside the effective dates of the insurance.	This error occurs when the patient’s authorization date range does not occur within the insurance’s effective dates.   To correct the issue, navigate to the patient’s chart and ensure the information for the concurrent review and insurance are entered correctly.	Error, not customizable
Authorization's insurance does not match billable item's insurance	This generally occurs when there is an overlapping authorization or the insurance on the Facesheet does not match the Payer List. To resolve this issue, please follow these steps to resync the auth with the insurance: Navigate to the facesheet. Review the authorization to confirm that the expected insurance is on the authorization. Then refresh the authorization by editing the auth and making a simple change (such as changing the status from approved to denied and then back to approved).  Click Update Authorization. Return to the billing audit tool report. Refresh the page to check if the error cleared. You can refresh the report by navigating away from, and then back to, the tab. Confirm that the error cleared. Note: The billing audit tool report may take 5-10 mins to update. If it does not update immediately, we suggest allowing the time to pass and then refreshing the report to check if the error has disappeared. If the error remains, contact Support.	Kipu EMR
Billing Provider is missing.	This warning appears when the billing provider is missing from the charge due to an incorrect Konnector set-up. To fix this issue, review the Konnectors set-up. Note: This error is known to occur when there is no default Konnector for the location.	Error, not customizable
Billing provider is missing NPI number.	This warning appears when the billing provider (whether added manually or auto-populated) is missing their NPI number. To fix this issue, either select a provider with an NPI or add the missing NPI number to the current provider.	Customizable
Building is missing	This warning appears when no building is selected for a billable item in a location where the Billing By Building feature is enabled. Verify that a building is selected on the patient's chart.	Error, not customizable
CCode/RCode is missing.	This error can appear for per diem items missing authorization. This error can appear for outpatient items and this issue occurs if the clinician did not select a service. To correct the issue: Is the form marked Ancillary? If yes, is the correct coding present within the template? If no, make the necessary changes. Was the code selected on the template? If yes, validate the code is present in Avea. If no, it is possible at the time the form was added it was not Ancillary. Make sure to add the code and save your changes. Note: Changes to templates are only going forward and not retroactive. This error can occur if there is an incomplete Replace billing rule in the Payer rule. To correct this issue:  1. Locate the payer rule. 2. Update the rule with the Ccode that is missing.	Error, not customizable
Claim Format is missing.	This error occurs when a billable item has codes present, but no claim format. Ensure that the billable item has a claim format selected.	Error, not customizable
Clinical LOC is missing.	This error occurs when no clinical level of care is documented on the patient's chart. A clinical LOC is required if the patient's payment method is set to a payment category of Private Pay or Non-Insurance. If the patient has insurance, ensure that the correct payment method is chosen. To resolve this, ensure the Payment Method is set up correctly in the Patient Settings as seen below. Choose a different option or update the Patient Settings. Also, ensure a payment method is selected on the Facesheet. Navigate to the patient chart, and confirm a payment method has been selected.  Note: for Private Pay workflows, please refer to Transmitting Billables for Private Pay/Non Insurance Patients	Error, not customizable
Date of service is after discharge date.	This generally occurs when there is a discharge date present. Please update the discharge date, the date of the service, or mark the item Do Not Bill.	Customizable
Date of service is before admission date.	To resolve, please review the patient's Admission Date. If the date/time is after the Start Time of the billable item, please update. If the Admission Date is correct, review the billable item. All billable evaluations should include the evaluation_start_and_end_time field to appropriately set the start and end times of the service and calculate duration. If you are using a legacy form with the evaluation_date field, this will automatically default the start time to midnight on the day in question which will lead to this error. Please update the form to use the evaluation_start_and_end_time field going forward.	Customizable
Diagnosis code is missing.	This issue generally occurs when no diagnosis code is present on the patient's chart. To resolve the issue, edit the facesheet and add the Diagnosis.	Error, not customizable
Incomplete items on this date: Missing Duration.	This issue occurs if the attached documentation for the billable item is missing the duration.  To resolve the error, navigate to the evaluation and ensure that the correct start/end times have been entered.  Once there is a valid duration on the item, the alert will go away.	Customizable
Incomplete items on this date: Missing Signature.	This issue occurs if the attached documentation for the billable item is missing signatures. The patient has an open evaluation or group session that has not yet been signed for this date.   Once all required signatures are added to the session/eval, this alert will go away.	Customizable
Insurance has been deleted from Payer Settings	Verify active insurance coverage on the patient's facesheet. If there is an insurance mismatch, remove and re-add the payer on the facesheet, ensuring to update the authorization so the new payer is recognized. Additionally, check that the insurance has not been deleted by looking under Settings > Payers.	Customizable
Insurance has improperly formatted termination date.	This error appears when the insurance termination date is not formatted correctly. To fix the error, return to the patient's facesheet and ensure that the termination date adheres to the 00/00/0000 format.	Error, not customizable
Insurance is missing [x]	The information specified in the alert is missing from the patient's insurance. Please navigate to the patient facesheet and update the missing information.  This error applies to all billing types, including when patient insurance of any type with an insurance payment method (i.e., not private pay, or non-insurance) has been selected as the payment method, but no insurance has been added.	Error, not customizable
Insurance is missing policy number.	This item appears if the insurance is missing the policy number. To correct the issue, navigate to the patient's chart and add the policy number to the insurance.	Error, not customizable
Insurance is missing subscriber address.	This item appears if insurance is assigned to a billing audit tool report but is missing any part of the subscriber's address (i.e., street, city, state, and/or zip code). To correct this issue, navigate to the patient's chart, and ensure that all address fields are filled out in the insurance section.	Error, not customizable
Konnector is missing.	This error appears when the billable item is not mapped to a default konnector. If available, an alternate, ancillary konnector may be selected from the konnector drop-down of the billable item for transmission.	Error, not customizable
Level of care authorization is in denied status on this date.	This warning appears on inpatient or attendance-based LOC authorizations when there is a denied authorization attached to a billable item.	Customizable
Level of care authorization is missing for primary insurance on this date.	This warning appears when the system cannot identify a Primary insurance authorization for the billable item. Possible causes: The patient has multiple insurances, and the Primary LOC authorization is missing while a Secondary/Tertiary LOC authorization is being applied. The patient has only one insurance, but the Insurance Priority field is blank (no priority set). The system interprets this as “no Primary insurance” and triggers the warning. Resolution: Review the patient’s insurance setup and confirm that the correct Insurance Priority is set.	Customizable
Level of care authorization is in new/pending status on this date.	When there is a New or Pending Auth per diem Billable Item the system treats the item as an outpatient/ancillary item until there is an Approved Auth on File. This can cause the billing provider to not populate as expected and will use the billable provider based on the hierarchy. This will also cause the Claim Format to default to Professional. To correct the issue: Update the authorization from New or Pending to Approved. Ensure there are no overlapping Auths and the Start/End Date of the Auth coincides with the DOS of the billable item. If the system does not automatically update the DOS to align with the now Approved Auth after five minutes, please reach out to the support team.	Error, not customizable
Level of care authorization is missing on this date.	This error occurs when the DOS on the billable item does not fall under any authorizations that are set to Approved or Denied. This error can also occur if the Utilization Review (UR) is missing, expired, or has mismatched insurance. To correct the issue: Step 1: Check if the Authorization is Present If the level of care (LOC) authorization is missing, an authorization for the LOC is required for per diem items. Step 2: Validate the Authorization If the LOC authorization is present, ensure the following: Authorization Type: The authorization must be LOC, not service. Services cannot replace LOCs if the template is set to billable only. Start/End Dates: The LOC start and end dates must match the date of service (DOS) of the billable item. Authorization Status: The LOC must be set to Approved. Finally, this error can occur when there is no matching LOC with the same name in Settings. To correct the issue: Navigate to the facesheet and edit the auth, being sure to choose a LOC name that matches one in the settings.  Click Update to save your changes. Note: Even if a LOC with the same name has been added to the Settings after the fact, the above steps must be completed for the changes to reflect in the billable item. Additional Notes: If using service authorizations, ensure the template is set to billable + ancillary if it’s for ancillary purposes. For per diem billing, you may need two templates: one for ancillary and one for per diem.	Error, not customizable
Location is missing.	This error occurs when the DOS on the billable item does not fall under any of the locations in the Location History on the patient's facesheet, which usually happens if the patient's admission date is backdated but the Location Date was not. It can also occur if the location is left blank or if the start date occurs before the patient was admitted. To correct the issue: Open the patient's facesheet to access their location history. Navigate to their location Hx. Either one of the following scenarios may apply: If there is a blank location: Delete the blank location by clicking the X. If the Start date is incorrect: Ensure no location history has a Start date before the patient’s admission date. For example, if the patient was admitted on 06/27/2024, ensure no location history entries have a Start date before this date.  If necessary, add the correct location by editing the facesheet, including the accurate location, and setting the Location date. Ensure that the Start date of any new location entries is the same as or after the admission date. Scroll to the bottom of the page and click Update to save the changes. Please allow at least 15 minutes for the billing audit tool report to reflect the change. If more than one location must be added, wait at least 5 minutes before adding the new location.	Error, not customizable
MAT doses included for future date.	This generally occurs when dispensing for any future dates. Bill the DOS, if appliable If no changes are needed, you may disregard the warning and transmit the charges.	Customizable
Maximum number of units exceeded on this date.	This error occurs when a Unit Billing payer rule has been configured and the Maximum Allowed Units are exceeded. To correct the issue: Please update the units on the billing audit tool report. If no changes are necessary, you may disregard the warning and transmit the charges.	Customizable
New diagnosis code added on this date.	This issue occurs when there are new diagnosis codes added to the patient after a default dx was established. You can review the diagnosis codes in the Edit Claim window or under the Diagnosis Codes section of the patient’s Billing tab.	Customizable
Overlapping services occurred on this date.	Validate that there are no overlapping dates for Billable and Billed Items. This issue appears specifically for ancillary-to-ancillary overlap OR non-ancillary services overlap on the same per-diem billable day.  In the expanded view, the overlapping services will display a warning icon so that it is easy to identify which services are overlapping.	Customizable
Patient program is missing.	This error occurs if the DOS on the billable item does not fall under any of the programs in the Program History on the patient's face sheet. Additionally, sometimes the program that is selected on the patient isn't turned on for that location. To correct the issue: Validate that a program is present on the patient's facesheet. Validate the program date matches the treatment date. In this example, we can see the date of service is before the start date for the program. Validate that the program is enabled for the Location by going to Initials > Settings > Programs and opening the Location drop-down. Validate that the evaluation document has an evaluation date.  If the form does not have an Evaluation Date, it will use the date the form was added to the chart. Validate that the Program is set up in the back end by clicking your initials > Settings > Clients/Patients > Programs. Check to see if the program selected on the patient's facesheet is found here.	Error, not customizable
Payment method is missing.	This error appears when there is no payment method documented, regardless of billing type.	Error, not customizable
Required hours not met on this date.	This error occurs when the configured required hours for that level of care has not yet been met for the day.	Customizable
Service authorization is in denied status on this date.	This warning appears on service authorizations when there is a denied authorization attached to the billable item.	Customizable
Service authorization is missing for primary insurance on this date.	This warning appears when a billable item does not have a primary insurance authorization but does have a secondary/tertiary insurance service authorization that is being applied.	Customizable
Service review insurance is missing external payer ID.	This error occurs when a service authorization is applied to a billable item and that service authorization's insurance is missing an external payer ID. This ID is usually is required for third party systems. Review the Payer List via Settings, and confirm Ext Payer ID is present. If yes, please contact billing support for additional assistance. If no, please add the Ext Payer ID Using CMD this would be the payer sequence number. Using Avea this would be the Electronic Payer ID within Practice Admin > Payers section. Note: When updating the Ext Payer ID if prompted to "Update payer information on linked records?" please Accept and Update All.	Customizable
Service authorization is missing on this date.	This error occurs when the Service Review billing rule has been enabled for codes included in the billing audit tool report, the item's billable type is outpatient/ancillary, and there is no service authorization attached for the chosen date. To fix this error, navigate to the patient's facesheet and add the service authorization.	Error, not customizable

Please note that these lists of errors and resolutions are not exhaustive. Please contact Support if you need assistance resolving any billing report errors.