You can enter either a Professional, Institutional or Dental claim. Claim entry requires more transaction code sets and you can access and edit them from those menus as well as setup the component.

The following topics describe settings for the Claim Entry/Edit function:

Selecting a Claim Entry/Edit CodeSet
Defining Claim Entry Settings
Creating Diagnosis Table

 

Follow the instructions below to edit or entry claims.

1.Select Claim Entry/Edit arrow Professional / Institutional / Dental Claim in the main menu.
 
editclaim
The "Claim Entry/Edit" menu
2.A screen like the one pictured below will be displayed. The following screen-shots will use the "Professional Claim" window.
 
claim
The "Professional Claim" window
3.Each segment or loop has its own set of editing screens listed on the left; they can optionally have different colors. The five (5) main data groups are:
Providers
Patient
Claim Information
COB
Service Lines

Click one of these menu items to open to the relevant screen.

left
The left menu in the "Professional Claim" window

4.Once you have accessed a main category screen, you will see the top menu to access the individual screen. Use it to navigate along the claim.
 
Below you can see the billing provider information from a claim that was loaded from the database. To see and edit other provider types use the tabs at the top of the screen. The following image shows all the provider types that are part of the Professional Claim implementation.
 
top-menu
The "Providers" tab selected in the "Professional Claim" window
 
Different sections may have a different range of tabs across the top. The following screen-shot shows top menu items for the "Service Lines" section selected in the left. This top menu differs from the top menu displayed on the previous screen-shot with the "Providers" section selected.
 
service
The "Service Lines" tab is selected in the "Professional Claim" window
5.To preview your changes, click "View Claim." A claim form will be shown on the screen.
 
preview1
The "View Claim" button
6.To save the changes, click "Save Claim."
 
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The "Save Claim" button