More Visit Information Claim Level

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 needed by payers to process claims. 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, do not add any additional information.

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 Dialog

More Info Dialog

1. Type:  If claim is related to an accident, place a check mark in box next to appropriate type of accident. Electronic claims allow for up to two types, CMS 1500 paper claims allow for only one type. If two boxes are checked for paper claims, the first type checked will print on claim. To add Illness, Injury, or Pregnancy dates, please see Dates tab

2. Special Program Codes: Special Program-Code indicating the Special Program under which the services rendered to the patient were performed

Delay Reason-Code indicating the reason a request was delayed

3. Primary:  Release of Information Signature-Code indicating whether the provider has on file a signed statement by the patient authorizing the release of medical data to other organizations

Signature Executed for Patient-Code indicating how the patient or subscriber authorization signatures were obtained and how they are being retained by the provider

4. Secondary: Release of Information Signature-Code indicating whether the provider has on file a signed statement by the patient authorizing the release of medical data to other organizations

Signature Executed for Patient-Code indicating how the patient or subscriber authorization signatures were obtained and how they are being retained by the provider