Billing Exceptions

In the WebPT EMR, when a patient is saved or documentation is finalized, the data is sent to WebPT Billing. If a data field is incorrect or missing, this field will prohibit the record from transferring to the Billing system. All rejected information will appear on the Billing Exceptions work queue in WebPT Billing. You must update the WebPT EMR or Billing application to resolve the exceptions.  Note: Inactivating or discharging the patient will not remove them from this report.

Important: In the event that we cannot retrieve the Rejection Reason, such as a result of an outage, the report will display the following: " Unable to determine reason. Please contact Support." This text will appear as a hyperlink to route the user to the Patient Record. 

Run the Report

  1. From the Reports menu, select Billing Exceptions
  2. If needed, select the appropriate Company, Practice, and Location. Enter a From Date and Through Date. It is recommended to enter a From Date of 30 days prior and a Through Date of today’s date. After you've entered your search criteria, click Search.

Report Layout

There are four possible exception types that display on this first page of the report. 

  1. Patient
  2. Case
  3. Charge
  4. Payment

The exception types should be worked in the order listed above, from #1-3. #4 (Payment) can be worked separately, as this exception type does not tie to the patient, case, and charge workflow. Click here for more information.

Why should I work rejection categories in order? 

Often, if an account rejects at the patient-level, the subsequent case- and charge-levels will also reject. Fixing the rejection at the patient-level will usually resolve the case and charge errors. 

Work the Exceptions

  1. Double-click on the Exception Type, starting with Patient (if available). 

  2. Double-click on an Exception Reason to display the accounts affected. 

  3. In the WebPT EMR, make the necessary changes to the corresponding patients and save. Provide ample time for the updated information to flow into WebPT Billing.
  4. Rerun the report to verify that the exception has been corrected.
  5. Follow steps 1-4 for all remaining Patient exception reasons and then proceed with Case exceptions, followed by Charge exceptions. Work Payment exceptions as needed.

Common Exceptions and Resolutions

Type Reason RevServe/RevEquip Resolution Self-Service Resolutions
Patient Invalid zip code Enter a valid 5- or 9-digit ZIP Code for the Patient or Responsible Party/Guarantor in the WebPT EMR. Enter a valid 5- or 9-digit ZIP Code for the Patient or Responsible Party/Guarantor in the WebPT EMR.
Patient Required field Phone is empty Update the patient’s chart in the WebPT EMR with a valid phone number. Update the patient’s chart in the WebPT EMR with a valid phone number. Do not include an extension.
Patient Invalid billing phone number Update the patient’s chart in the WebPT EMR with a valid phone number. Update the patient’s chart in the WebPT EMR with a valid phone number. Do not include an extension.
Patient Invalid phone number Update the patient’s chart in the WebPT EMR with a valid phone number. Update the patient’s chart in the WebPT EMR with a valid phone number. Do not include an extension.
Patient Required field City is empty, Required field State is empty, Required field ZIP is empty Add the City for the Patient or Responsible Party/Guarantor in the WebPT EMR. Add the City for the Patient or Responsible Party/Guarantor in the WebPT EMR.
Patient Invalid Billing zip code Enter a valid 5- or 9-digit ZIP Code for the Patient or Responsible Party/Guarantor in the WebPT EMR. Enter a valid 5- or 9-digit ZIP Code for the Patient or Responsible Party/Guarantor in the WebPT EMR.
Case Missing Required Subscriber Records Primary/Secondary insurance is missing subscriber information. Confirm that each payer has Policy Dates and check fields for extraneous spaces. Primary/Secondary insurance is missing subscriber information. Confirm that each payer has Policy Dates and check fields for extraneous spaces.
Case Required field Auth Num is empty Verify that an Authorization # has been included on the patient’s case or use the appropriate placeholder 0000.  Verify that an Authorization # has been included on the patient’s case or use the appropriate placeholder 0000. 
Case Invalid primary subscriber record, missing required field: Policy Num Verify that all insurance information is entered for the patient on their chart in the WebPT EMR.  Verify that all insurance information is entered for the patient on their chart in the WebPT EMR
Case Case history failed for case Id 19084028 having original case Id 19036726 and exception message Transaction (Process ID 936) was deadlocked on lock Reprocess the charge. Reprocess the charge.
Charge Amount is required The CPT Code is missing the Standard Charge Amount in Billing. Email updates@webpt.com with the correct charge amount.  The CPT Code is missing the Standard Charge Amount in Billing. Update the related Procedure Code and reprocess. 
Charge Adding(Edit) Charge: Billing provider must be a PT Email edi.help@webpt.com to update the Billing Provider. Review how the provider is set up in Billing. Ensure the provider is a Billing Provider with the PT Speciality.
Charge Dx Code XXXXXX cannot find lookup value
If this is a valid diagnosis code, email updates@webpt.com. If not a valid diagnosis code, have your therapist do an addendum on the EMR, choose a valid diagnosis code, Finalize & Rebill.
Typically, this rejection is caused by an inactive diagnosis code. If the Dx Code needs to be reactivated for Billing purposes, see Diagnosis Code Help.
Charge Required field MD_Code cannot find lookup value Complete the Referring Physician’s profile in the EMR and verify they are on the case. Check for any extra spaces. Once updated, complete an addendum on the affected note and select the option to Finalize and Rebill to add the Referring Physician to the charges. Complete the Referring Physician’s profile in the EMR and verify they are on the case. Check for any extra spaces. Once updated, complete an addendum on the affected note and select the option to Finalize and Rebill to add the Referring Physician to the charges.
Charge Required field Dx1 has empty value. This insurance requires ICD9 DX Codes. Verify that the insurance’s ICD-10 Date Effective box is unchecked in the EMR. Also, ensure that ICD-9 codes have been entered on the case in the EMR, not ICD-10 codes. Verify that the insurance’s ICD-10 Date Effective box is unchecked in the EMR. Also, ensure that ICD-9 codes have been entered on the case in the EMR, not ICD-10 codes.
Charge Required field Dx1 has empty value. This insurance requires ICD10 DX Codes. Verify that the insurance’s ICD-10 Date Effective box is checked and dated correctly in the EMR. Also, ensure that ICD-10 codes have been entered on the case in the EMR, not ICD-9 codes. Verify that the insurance’s ICD-10 Date Effective box is checked and dated correctly in the EMR. Also, ensure that ICD-10 codes have been entered on the case in the EMR, not ICD-9 codes.
Charge Adding a Charge: Future DOS Charges cannot be imported for a future date. Addend the note with the correct date. If the procedure was selected in error, complete an addendum to change/remove the code from the note. Charges cannot be imported for a future date. Addend the note with the correct date. If the procedure was selected in error, complete an addendum to change/remove the code from the note.
Payment Payment added/edited/deleted when month is closed Follow the steps described here.
Follow the steps described here.

All missing or incomplete information needs to be updated in WebPT. After the information is corrected and the account information is re-saved, check the Claims Feed Report. The transmission status should read Transmission Successful. This means the updated information exported into WebPT Billing. In WebPT Billing check the Billing Exceptions work queue to verify that the account is removed from the report.

Reprocess the Exceptions

When an integration message fails due to information not corresponding to information in WebPT Billing, the item can be reprocessed instead of completing an addendum.

  1. From the initial results, double-click on an Exception Type.
  2. Next, double-click on an Exception Reason.
  3. Check all items you want to reprocess. 
  4. Click Reprocess.

Remove the Exceptions

While this feature works for all exception reasons, it is most commonly used for Payment exceptions. If there is a Payment exception that you do not need to reprocess, you have the ability to remove it from this report. This is useful if the failed transmission was manually entered into WebPT Billing. 

  1. From the summary page, double-click on an Exception Type.
  2. Next, double-click on an Exception Reason.
  3. Check all items you want to remove.
  4. Click Remove, and then click OK.
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