You can view the procedures; change the diagnosis codes; view patient, subscriber, and payer information; change billing and rendering provider information; and change claim information for a claim.
To view claim details
How to get there
On the Home menu, under Third-Parties, click (or tap) Unsent Claims.
The Unsent Claims page opens.
How to get there
On the Home menu, under Third-Parties, click (or tap) Sent Claims.
The Sent Claims page opens.
How to get there
Use the Patient Search box to access a patient's record.
Notes:
If the last patient record you accessed since you last logged on is the correct patient's record, you do not need to re-enter the patient's name in the Patient Search box.
You can include inactive patients in the search results by setting the Include inactive patients switch to On.
On the Patient menu, under Third-Party, click (or tap) Third-Party Claims.
The patient's Third-Party Claims page opens.
How to get there
Use the Patient Search box to access a patient's record.
Notes:
If the last patient record you accessed since you last logged on is the correct patient's record, you do not need to re-enter the patient's name in the Patient Search box.
You can include inactive patients in the search results by setting the Include inactive patients switch to On.
Do one of the following:
On the Patient menu, under Financial, click (or tap) Ledger.
The patient's Ledger page opens.
The Claim Detail dialogue box appears.
Unsent Claim
Queued, Sent, Printed, Rejected, or Received Claim
View the details as needed on any of the following tabs:
Procedures
The Procedures tab displays the associated procedures.
For the procedures on the claim, the associated diagnoses appear. You can have up to four diagnosis codes per claim. You can remove diagnosis codes as needed (by clicking, or tapping,
on the coresponding codes).
Note: Removing diagnosis codes from a claim does not affect the corresponding procedures. All diagnoses remain attached to their corresponding procedures as currently posted in the patient's ledger and progress notes.
If you have less than four diagnosis codes, you can add an diagnosis to the claim by selecting a diagnosis from the Select a diagnosed condition list. Only the diagnoses attached to the claim's procedures (as currently posted in the patient's ledger) are available for selection. If there are two, three, or four diagnosis codes, select the one that you want to be the primary diagnosis.
General
The General tab displays billing and rendering provider information, the pay-to address, patient information, subscriber information, and payer information.
You can change the Billing Provider and/or Rendering Provider. Only providers who have access to the location where the claim was created are available.
Claim Info
The Claim Info tab displays the name of the Referring Provider, the Reference Number, Orthodontia information (months remaining; and total months, the default value of which is calculated automatically, based on the placement date and remaining months specified, if the claim was created for orthodontic treatment), and the Place of Service for the associated treatment.
You can enter or change any of this information.
Do one of the following:
Click (or tap) Save and then Cancel to save and close the dialogue box.
Click (or tap) Submit to save the changes and submit the claim.
Click (or tap) Resubmit to save the changes and resubmit the claim.
Click (or tap) Print and then OK on the message that appears to create the claim as a PDF file that you can print.
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