Create standalone e-claim

There are several ways to create a standalone claim.
 

Step 1. Select E-Claims > Create New E-Claim from the menu.
       Electronic Claim form opens. Patient Details tab is active.

Step 2. Fill in available patient data or load patient data using Find Patient field.

Step 3. Go to Patient Visit tab.

Step 4. Enter visit details.

• • Start Date is today by default. End Date must be greater than or equal to Start Date.
    If user clicks on Set today as patient visit date link label then Start Date switches to today's date.
  • Visit Type is 1 - No bed + No emergency room by default, Visit Start Type and Visit End Type are empty. If Visit Type = 3 - Inpatient bed + No emergency room or 4 - Inpatient bed + Emergency room, then Visit End Type and Visit End Date become mandatory.
  • Diagnosis Type can be Principal, Secondary, Admitting. Principal diagnosis is a mandatory one and can be set only once in the claim. At the same time e-claim may have several Secondary and Admitting diagnoses.
  • ICD9 Diagnosis can be selected from the corresponding search list which open by clicking on […] button. Another option is to enter the value or part of it manually in the field (e.g. code 098.49) and press Enter key. The data will load automatically.

Learn more

Step 5. Go to Procedure Details tab.

Step 6. Enter activities details.

1. • Type can be one of the following: CPT, HCPCS, Trade Drug, Dental, Service, APR-DRG.
   • Procedure, or activity, is selected from the list for the corresponding procedure type, Ordering Clinician – from the list of clinician licenses by clicking on […] button (or entering the value manually in the field and press Enter key).
   • Unit Gross Price, Patient Share, Unit Net Price are set manually. Unit Gross Price must be equal to Unit Patient Share + Unit Net Price. Procedure may have zero prices. However, at least one procedure must have Unit net price > 0. Trade drug must always have a price.
   • Quantity can be decimal in the range (0.0001; 999.9999).
   • Selected Procedures grid shows summary on all procedures added to the claim.
   • Totals line shows Total Gross amount, Total Patient Share, Total Net amount values for all procedures.

Learn more

Step 7. Click on Save button.
       An information dialog appears informing that the claim is saved in the database.

Step 8. Click on OK button.
       Electronic Claim form closes. The claim is saved.

ALTERNATIVE WORKFLOWS

Create e-claim from Find Patient form

1. Select Patient > Find Patient from the menu. 
   Patient Search form opens.
2. Set search value and click on Search button. 
   Search results grid appears.
3. Set focus on any record and click on Add Claim button. 
   Electronic Claim form opens. Patient Details tab is active and the patient data is already filled in.
4. Go to Patient Visit tab and fill the data.
5. Go to Procedure Details tab and fill the data.
6. Click on Save button. 
   An information dialog appears informing that the claim is saved in the database.
7. Click on OK button.
   Electronic Claim form closes. The claim is saved.

Create e-claim from Find & Submit E-Claims form

1. Select E-Claims > Find E-Claims from the menu. 
   Find & Submit E-Claims form opens.
2. Click on Add button. 
   Electronic Claim form opens. Patient Details tab is active.
3. On Patient Details tab fill patient data.
4. Go to Patient Visit tab and fill the data.
5. Go to Procedure Details tab and fill the data.
6. Click on Save button. 
   An information dialog appears informing that the claim is saved in the database.
7. Click on OK button.
   Electronic Claim form closes. The claim is saved.