More Info Misc Details-Original Reference Number/ICN

Billing -> Patient Account -> New Charges Tab ->More Info

or

Billing->Patient Account->Claims tab->Select claim from list->More Info

The More Info dialog consists of several tabs for additional visit information when needed by payers to process claims correctly. Many specialties require specific dates, certification numbers, etc. Additional information can be added by clicking on the appropriate tabs. The information entered here will be at the claim level and will apply to all charges within the claim. Unless this additional information is required by the payer for your specialty, leave blank.

For charge level only information, you can add information in the Charge Details by double clicking on a specific charge in New Charges tab or when editing charges in the patient Claims tab.

More Info Misc Details-Original Reference Number/ICN

If claim submission is Replacement claim, the ICN or Original reference number will be entered here.

1. Number: Enter ICN/Original Reference Number as shown on explanation of benefits or rejection report.

2. Policy ID: Select payer from drop down list. This list is pulled from the insurance policy information in patient Insurance demographics.

Note: Claim Submission must be changed to the appropriate qualifier after it's rebuilt in Claims Manager:

Original

Corrected (Institutional claims)

Replacement (Professional claims)

Void