Issue with Posting PreAuth Claim

[beacondental]

Hello,

I tried posting a pre-auth claim using the Claim POST API, with the below Request Object,

patNum=38663, procNums=[1704688], claimType='PreAuth', insSubNum=35025, patRelat='Self'

The request object is as expected by the POST API, but I am getting the below error,
400 Bad Request: ""Cannot create a PreAuth claim with procedures from a saved treatment plan.""

But when I tried checking the TPStatus for the ProcNum 1704688 using treatplan, procedurelog & treatplanattach tables, I found the TPStatus as 1, which is Active, then why the error?

Please guide me with a solution for the above-mentioned issue.

Thanks in advance.

[beacondental]

Hello API Team, Can you please help me with this process, as are development has stalled unless we get clarity.

[SLeon]

Good morning,

You are attempting to use a procedure with an incorrect status. From our schema:

PrecedureLog.ProcStatus.png (19.33 KiB) Viewed 12234 times

As the error message indicates, you cannot use procedures that are of type TP.

[beacondental]

Thanks for the previous help.

One more question I have is, how can I find the Pri Ins Amount shown in the treatment plans module for an active treatment plan?

If you can help me with the query or the API, it will be very helpful.

Thanks in advance.

[RyanH]

Thanks for the previous help.

One more question I have is, how can I find the Pri Ins Amount shown in the treatment plans module for an active treatment plan?

If you can help me with the query or the API, it will be very helpful.

Thanks in advance.

Hello beacondental,

You can use Query #982 with the Queries endpoint to retrieve the ‘Pri Ins’ column shown in the Treatment Plan Module through the API.

Thanks!

[beacondental]

Good morning,

You are attempting to use a procedure with an incorrect status. From our schema:

PrecedureLog.ProcStatus.png


As the error message indicates, you cannot use procedures that are of type TP.

I am already checking the ProcStatus=1 in my query. Still, I see this error.

Also, the ProcNum from the example I shared in the beginning of this thread is part of an Active Treatment Plan only, then why the error?

[RyanH]

Good morning,

You are attempting to use a procedure with an incorrect status. From our schema:

PrecedureLog.ProcStatus.png


As the error message indicates, you cannot use procedures that are of type TP.

I am already checking the ProcStatus=1 in my query. Still, I see this error.

Also, the ProcNum from the example I shared in the beginning of this thread is part of an Active Treatment Plan only, then why the error?

Hello beacondental,

The error message you sent indicates that the procedure you’re attempting to create a PreAuth claim for has been saved to a Saved TP. To verify this, you can use the Query endpoint to find all ProcTPs with a ProcNumOrig equal to the procedurelog.ProcNum.

For more information, see our ProcTP Database Schema and our ProcTP API documentation.

Thanks!

[beacondental]

Hello,
I selected procedures from the Active Treatment Plan and attempted to create a Pre-Auth claim, but encountered the same error:
"Cannot create a PreAuth claim with procedures from a saved treatment plan."
I’ve attached the relevant screenshots.
Could you please guide us on this matter? This issue has been ongoing for quite some time and is currently stalling our development efforts.
""

[justine]

Hello,
I selected procedures from the Active Treatment Plan and attempted to create a Pre-Auth claim, but encountered the same error:
"Cannot create a PreAuth claim with procedures from a saved treatment plan."
I’ve attached the relevant screenshots.
Could you please guide us on this matter? This issue has been ongoing for quite some time and is currently stalling our development efforts.
""

Hello beacondental,

You cannot create a preauth claim for procedures that are on a saved treatment plan. Specifically, this error occurs when there are procTPs.ProcNumOrig values that match supplied procNums.

For example, if you were to call

Code: Select all

https://api.opendental.com/api/v1/proctps?TreatPlanNum=65212

and parse the return for ProcNumOrig=1574434, this indicates that procedurelog 1574434 is associated with saved treatment plan 65212. This can only happen if treatplannum 65212 is for a saved treatment plan.

Thanks!

[obv123]

Hello OD team,

I am experiencing the same issue as beacondental. I have read and understood the conversation so far. My additional question is:

In the OpenDental UI it is possible to save and sign a TP and then create a PreAuth for the same procedures by selecting them from the "active" treatment plan. Is there any way to do an equivalent thing through the API?

Best,
Alex

[RyanH]

Hello OD team,

I am experiencing the same issue as beacondental. I have read and understood the conversation so far. My additional question is:

In the OpenDental UI it is possible to save and sign a TP and then create a PreAuth for the same procedures by selecting them from the "active" treatment plan. Is there any way to do an equivalent thing through the API?

Best,
Alex

Hello obv123,

If you’d like to recreate the described workflow via API, it is recommended to first create your PreAuth claim before saving and signing a treatment plan.

Thanks!

[obv123]

Hi RyanH,

Thank you for the response. Your suggestion makes sense. Unfortunately, it's our process to have the patient sign the treatment plan before they leave the appointment where the services were planned. The prior auth claim gets created later after review from our billing team (which is part of what we're trying to automate).

Is there any way I could request a modification to the post claims endpoint to support this?

Thank you,
Alex

[RyanH]

Hi RyanH,

Thank you for the response. Your suggestion makes sense. Unfortunately, it's our process to have the patient sign the treatment plan before they leave the appointment where the services were planned. The prior auth claim gets created later after review from our billing team (which is part of what we're trying to automate).

Is there any way I could request a modification to the post claims endpoint to support this?

Thank you,
Alex

Researching the support of this workflow has been added to the API development list. We will reply to this thread when complete.

Thanks!