Claims Tab

View claims associated to patient account. Edit and place claims On Hold for resubmission, if needed from this location.

Patient Claims View

1. Claims: A listing of all patient claims On Hold, Pending Scrub, Submitted or Processed.

2. Claim Details: The claim details listed in this section represent the claim that is selected in the Claims list above.

3. Double click the line item to further view or edit charge details.  

4. View additional claim info.

5. Patients Primary insurance Policy.

6. Patients Secondary insurance Policy

7. Manually change the Status of a claim:

On Hold: If making changes, place a check mark in the On Hold box to move a claim to that section in the Claims Manager. The claim must be Rebuilt to include changes on the the visit.

Processed: If you want to make the balance on a claim the patients responsibility, place  a check mark in Processed box.

If the claim is in the Claims Manager, this will also remove it from the Claims Manager.  

If a claim is in the Processed status, but you want to resubmit to insurance and make it Insurance pending status, you can click to take the check mark out and resubmit claim.

8. File With: Drop down to select Primary or Secondary policy. If a secondary claim has been generated, and the primary payer has automatically forwarded it to the secondary payer, remove the claim from the Claims Manager by selecting the Crossover option from the list.

9. Route: Select the routing to submit claim Paper or Electronic.

 

10. Paper Fill: Paper claims only allow four diagnosis codes per visit. If you have more than 4 codes per visit, you will need to make a selection if you want to use the primary 4 codes and use the fewest pages or if you want to use more than four diagnosis codes and maintain order.