Purpose
The Insurance Pending Procedures Report helps the practice identify completed procedures that:
Have not yet been billed to insurance, or
Have insurance discrepancies preventing proper claim processing
This report highlights three specific conditions that require action to ensure timely and accurate insurance billing.
1. Completed Services Not Billed to Insurance
Identifies completed procedures with no claim created due to billing order set to “N”
Action Required: Review the billing order for accuracy for each completed code, and create claims promptly
2. Completed Services with Insurance Mismatch
Identifies procedures where the insurance attached to the procedure does not match the patient’s current insurance plan on file
Action Required: Correct the insurance details and recreate or update the claim as needed
3. Completed Services with Claims Pending Creation
(Batch claims required for completed procedures with billing order set to “D” and valid insurance attached)
Identifies procedures ready for claim creation but not yet included in a batch or individual claim
Action Required: Generate claims (individually or via batch claims processing and extend your date range)
Best Practices
Review this report daily to avoid delays in billing
Resolve all items promptly to maintain accurate and timely insurance submissions
Weekly for auditing completed procedures that may have been missed
Before month-end closing to ensure all completed procedures have been billed correctly
Periodically back date your date range for previous months to ensure past corrections are found
Step-by-Step: How to Generate the Report
Step 1: Navigate to the System Menu > select Operational Reports under Insights
Step 2: Click the + Icon on the left or the Generate Report button on the right to access the report filters.
Step 3: Configure Filters
Condition
Completed Services Not Billed to Insurance
Completed Services with Pending Primary Claim Creation
Completed Services with Insurance Mismatch
Date Range:
Select Date of Service (DOS) range: One Month (1M)
Location
Select the specific practice location(s) if the practice has multiple offices.
Additional Filter Options
Exclude Do Not Bill to Insurance Codes
Excludes procedure codes with a default billing order = N
Exclude Ortho Codes Attached to Payment Plans
Excludes orthodontic procedures linked to payment plans.
| ⭐ Save Filter: To preserve your selections for future use |
Summary view is useful for quick monitoring of outstanding insurance work.
Click the blue-colored entries to view more information on the corresponding entries.
Access & Permissions
If the report is not visible - connect with a super admin at your office to enable your permissions.