Bill Status Codes and Resolutions
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Last Modified on 09/18/2024 11:59 am EDT

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Services are converted to Line Items using the Recalc functionality in NSS Billing. Each Line Item consists of a responsible party, an associated dollar value, and a Procedure Code. If Recalc finds an issue with the Service, the user is informed of a Bill Status error, which can be corrected for the Service to be successfully converted to a Line Item. Within the Services Form, Services that have no errors display a Bill Status of "0" and become Line Items. If a Service has a Bill Status other than "0", the issue must be resolved before a Service can be converted to a Line Item. To view a list of all statuses and a short description within NSS Billing, click the Bill Status button. Bill status codes can be found:

  •  In the Bill Status Desc column in the Services Form grid
  •  By highlighting a Service and reviewing the Bill Status field in the lower left-hand corner of the window

Below you will find a list of the most common Bill Status codes and suggested resolutions. Use the Filter field to search for a specific Bill Status code.

Bill Status Code
Description

Resolution

3
"This Service is not billable for this duration."

The Activity Code has a minimum duration and the Service has not met that duration.

The duration of the Service needs to be updated or the Activity Code minimum needs to be updated. To edit Minimum Time to Bill, see Edit the Master Activity Code Form in Edit an Activity Code.

4
"No Rate record established for Prof (professional) type."

  • The Service code on the Activity Code has a Discipline without a rate.
  • The Allow Service For This Discipline checkbox is not checked. 
  • The Service is outside the effective dates.

Navigate to Activity Code Rate Form for Services and edit the Discipline Rate, Allow Service For This Discipline checkbox, or effective dates for an Activity Code. See Edit Service Rate Information for an Activity Code in Edit an Activity Code.

11
"Add this contact type, and make it billable. Or change this contact type to a billable contact type."

When billing the Party Type of the client's insurance, the Place of Service (POS) is not listed under the Contact Billable section for the Activity Code insurance coverage.		To add a billable place of contact, navigate to the Contacts Billable Type List: Maintenance and Setup > Activity Codes > Activity Codes > Select Activity Code > Ins Coverage button > Select Party Type > See: Step 4: Add Activity Code Billable Place of Service in Set Up an Activity Code.
16
"Review client insurance caps."

Insurance requires Authorization (caps) for this Service, but the client does not have a valid Authorization in the system.

Most agencies use NSS to manage Authorizations via the Authorization Tracking widget. In this case, an Authorization needs to be added through either the Face Sheet or a Note/Form. The Authorizations require Confirm To Billing to be selected for them to show up in the details section of client insurance. See: Add a New Authorization.

17
"Add client insurance coverage."

The client does not have insurance in effect on this date of service or there is no insurance plan listed for the client.		Edit Effective Date:
  • Within NSS Billing: Client Insurance > Search for client > Select Insurance > Details button > Edit Effective Dates button > Edit button.
  • Within NSS, Insurance widget: Face Sheet > Search for client > Edit button > Insurance > Select Insurance > Effective Dates > Edit button.

Add Client Insurance:

19"Visits Cap exceeded"

Insurance requires Authorization (caps) for this Service, and the visit-based cap in place for the client has been reached.		A new Authorization needs to be added or write the Service off depending on the situation.
24"Update this Clients Face Sheet, missing date of birth."

Date of birth (DOB) is missing from client's Face Sheet.		To add a DOB to the Face Sheet: Admissions > Face Sheet > Search for Client > Edit button.
25
"Note sealed without a diagnosis, or clients DSMV missing diagnosis."

The client is missing a diagnosis.		Most NSS agencies have the Diagnosis field as required when sealing a Note (for task-based billing) which would not cause this error. For schedule-based billing or any task-based billing system where that is not the case, a diagnosis can be added through any DSM-V widget in NSS.
29"Client has no Physician on record."

The Primary Clinician on Face Sheet is missing.		To add a Primary Clinician to the Face Sheet, navigate to the Face Sheet: Admissions > Face Sheet > Search for Client > Edit button > Select Primary Clinician.
30"Subscriber Number missing on Insurance."

Subscriber Number is missing on the client's insurance.

Edit the client's insurance to add Subscriber Number:

  • Within NSS Billing: Client Insurance > Search for client > Select Insurance > Edit Insurance button > Edit button.
  • Within NSS, Insurance widget: Face Sheet > Search for client > Edit button > Insurance > Edit button.
32"No proc code & Party isn't private pay."

The Activity Code insurance coverage for this Activity Code/Party Type does not have a procedure code value listed.		To edit a procedure code on an Activity Code, navigate to Activity Code Insurance Form, see Edit Insurance Coverage Information for an Activity Code in Edit an Activity Code.
35"OUT OF DATE did not pass Quarterly Plan Edit"

The Quarterly Review Required for Billing check box is checked on the client's insurance form and they either don't have any records in the Client Review / Plan Dates List or the max Date Completed is before the service date.
Uncheck the Quarterly Review Required for Billing checkbox on the Client Insurance form, and/or make sure the Date Completed for the Review is after the service date.
36"No Doc on site & incident to flag is on."

The Bill "Incident To" option is checked under Configuration Options and the Provider Type of the staff enrollment for this service is not an MD or a DO.		To edit Configuration Options: Maintenance and Setup > Configuration Options > System tab > Page 1 > Bill "Incident To" checkbox. To edit the Provider Type of staff enrollment for the service, navigate to the Staff Enrollment Form:  Maintenance and Setup > Employees > Staff > Staff > Select the Staff > Ok button > Enrollment List button > Ok button > Edit button.
99"Awaiting Re-Calc"


Service has not been processed yet.

To process Services, see Convert Services into Line Items.
101
"Activity Code not covered by this insurance."

The Activity Code does not have an Activity Code insurance coverage entry for the Party Type for the client's insurance.		To add Activity Code insurance coverage for the Party Type, see Step 3: Add Activity Code Insurance Coverage in Set Up an Activity Code.
102"No bill rate code on file"

The Activity Code insurance coverage for this code/Party Type is missing a billing rate code entry.		To edit a billing rate code for the Activity Code, navigate to Activity Code Insurance Form. See Edit Insurance Coverage for an Activity Code in Edit an Activity Code.
103
"Update Staff Enrollment, this staff member is not enrolled to bill for this Party Type."

Staff is not enrolled to bill the Party Type of the client's insurance. Staff enrollments are auto-populated during implementation but need to be maintained afterward.		To add a staff enrollment, navigate to the Staff Enrollment Form:  

Maintenance and Setup > Employees > Staff > Staff > Select the Staff > See Step 3: Staff Enrollment Setup in Setup Billable Staff.

104
"Enrollment information indicates this clinician cannot deliver this type of service."

  • Under Staff Enrollments, there must be a Provider Type filled out. For billing Medicare, Party Type 1, the Provider Type on Staff Enrollment must be an MD, DO, CSW, or CP. 
  • If the staff member has a Provider Type of CSW or CP and on the Contacts Billable page for this activity code, insurance coverage does not have the Billable as CSW/CP box checked.
  • When a client's insurance has the Physician Outpatient Services Covered or Non-Physician Outpatient Services Covered boxes unchecked on Page 3 (or Page 2 in VFO). These boxes are checked by default but can become unchecked if the client is entered with a private pay insurance plan (where it is not checked by default) and then converted to a commercial insurance plan.

  • To edit the Party Type for staff enrollment, navigate to the Staff Enrollment Form:  Maintenance and Setup > Employees > Staff > Staff > Select the Staff > Ok button > Enrollment List button > Select Party Type > Ok button > Edit button.
  • To edit a contact billable type, navigate to the Contacts Billable Type List: Maintenance and Setup > Activity Codes > Activity Codes > Select Activity Code > Ins Coverage button > Select Party Type > Contacts Billable button >  Select Contact Type > Ok button > Edit button > Select Billable as CSW/CP checkbox.
  • To edit client insurance, navigate to the Client Insurance Form within NSS Billing: Client Insurance > Search for client > Select Insurance > Edit Insurance button > Edit button > Page 3 tab (Page 2 tab in VFO) > Select checkboxes for Non-Physician Outpatient Services Covered and Physician Outpatient Services Covered.

107"CR Consumer Progress Note Required For Billing"

Legacy VPO bill status.		To edit client insurance in the VPO Billing Engine, navigate to the Client Insurance Form: Client Insurance > Search for Client > Ok button > Select the insurance > Edit Insurance button > Page 3 tab > Page 3 tab > Edit button > Select the CR Consumer Progress Note Required for Billing? checkbox.
108"Insurance not billable to this client for this Activity Code."

This Activity Code is listed under the Activity Code Exclusion box under Details on Client Insurance.		To edit the Activity Code exclusion, navigate to the Client Insurance Activity Code Exclusion Form: Client Insurance > Search for client > Select Insurance > Details button > Activity Code Exclusion button.
109"Activity Code excluded from billing to this insurance." 

There is an entry for this Activity Code/Insurance combination under Activity Code Insurance Exclusion.		To edit the Activity Code Insurance Exclusion List: Maintenance and Setup > Activity Codes > Activity Code Insurance Exclusion > Select Activity Code to Edit > Edit button.
111"Subscriber First Name required when electronic submission!"

Client insurance is missing the subscriber's first name.

Edit the client's insurance to add the subscriber's first name:

  • Within NSS Billing: Client Insurance > Search for client > Select Insurance > Edit Insurance button > Edit button.
  • Within NSS, Insurance widget: Face Sheet > Search for client > Edit button > Insurance > Edit button next to Insurance.
112"Subscriber Last Name required when electronic submission!"

Client insurance is missing the subscriber's last name.

Edit the client's insurance to add the subscriber's last name:

  • Within NSS Billing: Client Insurance > Search for client > Select Insurance > Edit Insurance button > Edit button.
  • Within NSS, Insurance widget: Face Sheet > Search for client > Edit button > Insurance > Edit button next to Insurance.
113"Subscriber Address required when electronic submission!" 

Client insurance is missing the subscriber's address.

Edit the client's insurance to add the subscriber's address:

  • Within NSS Billing: Client Insurance > Search for client > Select Insurance > Edit Insurance button > Edit button.
  • Within NSS, Insurance widget: Face Sheet > Search for client > Edit button > Insurance > Edit button next to Insurance.
114"Subscriber City required when electronic submission!"

Client insurance is missing the subscriber's city.

Edit the client's insurance to add the subscriber's city:

  • Within NSS Billing: Client Insurance > Search for client > Select Insurance > Edit Insurance button > Edit button.
  • Within NSS, Insurance widget: Face Sheet > Search for client > Edit button > Insurance > Edit button next to Insurance.
115"Subscriber State required when electronic submission!"

Client insurance is missing the subscriber's state.

Edit the client's insurance to add the subscriber's state:

  • Within NSS Billing: Client Insurance > Search for client > Select Insurance > Edit Insurance button > Edit button.
  • Within NSS, Insurance widget: Face Sheet > Search for client > Edit button > Insurance > Edit button next to Insurance.
116"Subscriber Zip required when electronic submission!"

Client insurance is missing the subscriber's zip code.		Edit the client's insurance to add the subscriber's zip code:
  • Within NSS Billing: Client Insurance > Search for client > Select Insurance > Edit Insurance button > Edit button.
  • Within NSS, Insurance widget: Face Sheet > Search for client > Edit button > Insurance > Edit button next to Insurance.
117"Subscriber Relation To Client required when electronic submission!"

Client insurance is missing the subscriber's relation to the client.		Edit the client's insurance to add the subscriber's relation to the client:
  • Within NSS Billing: Client Insurance > Search for client > Select Insurance > Edit Insurance button > Edit button.
  • Within NSS, Insurance widget: Face Sheet > Search for client > Edit button > Insurance > Edit button next to Insurance.
119"Diagnosis marked as non-billable on client insurance."

There are diagnosis entries in the Diagnosis Billable list of the client's insurance.		If this Diagnosis should be billable, to add a new Diagnosis Billable, navigate to the Client Insurance Details list: See Add Client Insurance in NSS Billing.
120"Insurance not billable to this client for this Place Of Contact!"

Place of Contact is listed under contact exclusions for the client's insurance.		If the Place of Contact should be billable, you need to remove the exclusion from the Place of Contact Exclusions list. Navigate to the Client Insurance Details List: See Add Client Insurance in NSS Billing.
121"Form was sealed without Date of Injury."

If insurance has a Category marked as Workers Comp or Auto, it requires a Date of Injury.		To add a Date of Injury:
  • In Virtual Front Office (VFO), navigate to the Client Master Form: File > Client > Client > Client Master > Search for Client > Client Status Sheet tab > Page 3 tab > Edit button.
  • In Virtual Private Office (VPO), navigate to the Client Dx/Tx Form: File > Client > Client Dx/Tx > ICD tab > Edit button.
122"Update this Clients Face Sheet, missing first name."

The client's Face Sheet is missing their first name.		To add the client's first name, navigate to the Face Sheet in NSS: Face Sheet > Search for client > Edit button.
123"Update this Clients Face Sheet, missing last name."

The client's Face Sheet is missing their last name.		To add the client's last name, navigate to the Face Sheet in NSS: Face Sheet > Search for client > Edit button.
124"Update this Clients Face Sheet, missing address."

The client's Face Sheet is missing their address.		To add the client's address, navigate to the Face Sheet in NSS: Face Sheet > Search for client > Edit button.
125"Update this Clients Face Sheet, missing city."

The client's Face Sheet is missing the city.		To add the client's city, navigate to the Face Sheet in NSS: Face Sheet > Search for client > Edit button.
126"Update this Clients Face Sheet, missing state."

The client's Face Sheet is missing the state.		To add the client's state, navigate to the Face Sheet in NSS: Face Sheet > Search for client > Edit button.
127"Update this Clients Face Sheet, missing zip code."

The client's Face Sheet is missing the zip code.		To add the client's zip code, navigate to the Face Sheet in NSS: Face Sheet > Search for client > Edit button.
128"Activity Code marked as not billable!"

The Activity Code is not marked as billable.		To make an Activity Code billable, navigate to the Master Activity Code Form and select the Billable Activity checkbox. See Edit the Master Activity Code Form in Edit an Activity Code.
129"Do Not Bill"

The Do Not Bill checkbox has been selected on the Services Form.		To make changes to the Do Not Bill checkbox on the Services Form, select the Service and click the Edit button.
130"Insurance Primary - Do Not Bill"

The Activity Code Insurance Coverage has the Stop If Primary checkbox selected for this Activity Code/Party Type.		To make changes to the Stop If Primary checkbox, navigate to the Activity Code Insurance Form. See Edit Insurance Coverage Information for an Activity Code in Edit an Activity Code.
131
"Service Duration more than max time."

The Activity Code has a maximum duration and the Service has not met that duration.

Update the duration of the Service on the Note or update the activity code Maximum Time to Bill in the Master Activity Code Form: Maintenance and Setup > Activity Codes > Activity Codes > Highlight Activity Code > Ok button > Edit button. 

140

"Agency error on Services Form. Click Edit-Save for more details."

There is no agency ID on the Service. Locations in NSS Clinical have to be linked to the Agency or a default Agency needs to be set.
  • To link a Location to NSS Billing, see Link Locations to Billing Engine.
  • To set a default Agency, navigate to Configuration Options: Maintenance and Setup > Configuration Options > System Tab > Page 1 > Default Agency drop-down.
141
"Program error on Services Form. Click Edit-Save for more details"
  • Most often, the client is not admitted to the program selected on the Service (and the Allow Billing With No Admission configuration option is not selected). 
  • The program selected from NSS is not properly linked to the program in billing.

(Virtual Private Office Only)


  • Change the client's admission or the program on the Service to the proper value.
  • The program selected from clinical will need to be properly linked to the program in NSS Billing: The Choice Value option for program under System Setup > Billing Setup tab > Select the Program checkbox > Edit Selected Field button > Choice Value in Clinical needs to match the System Code ID associated with the selected program from the System Codes Form in NSS Billing, Maintenance and Setup > System Codes > Select a Code > Ok button.
142"Staff error on Services Form. Click Edit-Save for more details."

Staff is missing from Service. This is not likely to appear unless someone is entering Services manually.		To add staff to the Service, select the Service, click the Edit button, and select from the Staff ID drop-down.
143"Service Date error on Services Form. Click Edit-Save for more details."

The service date is in the future.		Edit the Service Date within NSS Clinical.
144 "Case Number error on Services Form. Click Edit-Save for more details."
  • This likely means the case has been discharged in Clinical but the client is still receiving Services.
  • If a case has been discharged but the client is still receiving Services when you click Edit-Save for more details, a pop-up is displayed that asks if you want to bill this anyway, click Yes if you want to bill for it.
145

"Activity Code error on Services Form. Click Edit-Save for more details."


  • The Activity Code selected in NSS did not resolve to an Activity Code in the Billing Engine.
  • In the VPO Billing Engine, the system performs an additional check to make sure that the client is admitted to the program in the program field on the Service. If there is no admission record, the error is generated.
  • If the Activity Code in Clinical did not resolve to an Activity Code in NSS Billing, check the Send to Billing Engine checkbox within Billing Setup in NSS:  Admin > System Setup > Billing Setup > Select Activity Code > Edit Selected Field button > Send To Billing Engine checkbox and Choice Value within this window needs to match to Activity Code ID in Billing Engine.
  • If you use VPO and want to turn off this flag for admissions, toggle on the Allow Services with No Admission checkbox: Maintenance and Setup > Configuration.
  • For VPO, you are more likely to see this issue during Implementation when the system is still being configured (using test clients and test services), in this case, admit records can be edited within NSS Billing: File > Client > Client > Client Admissions. However, if this is happening after your Go-Live with NSS, it is recommended that you correct the admission record in Clinical so that the information flows over to NSS Billing.

  • For VPO, verify the Allow Service for This Discipline? checkbox is checked by going to Billing Engine: Maintenance and Setup > Activity > In the Master Activity Code List Search and Select an  Activity code > Srv Rates to open up the Activity Code Rate Form for Services. Verify the Allow Service For This Discipline checkbox is checked.  

146"Place of Contact error on Services Form. Click Edit-Save for more details."

Place of contact is missing from Service. This is not likely to appear unless you are entering Services manually.		To edit the Place of Contact/Service on a Service, navigate to the Services Form: Navigation Form > Services button > Enter search criteria > Ok button > Select the Service > Edit button.
149"Start time error on Services Form. Click Edit-Save for more details."

Start time is missing from Service. This is not likely to appear unless you are entering Services manually.		To edit the Start Time for a Service, navigate to the Services Form: Navigation Form > Services button > Enter search criteria > Ok button > Select the Service > Edit button.
150"End time error on Services Form. Click Edit-Save for more details."

End time is missing from Service. This is not likely to appear unless you are entering Services manually.		To edit the End Time for a Service, navigate to the Services Form: Navigation Form > Services button > Enter search criteria > Ok button > Select the Service > Edit button.

Tags: Services

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