Claim Processing

Whether processing electronic claims or printing to standard forms, the steps necessary to generate the claim are simple yet flexible. Electronic claims may be processed for a selection of approved clearing houses. MicroFour strives to have cost effective and reliable choices available throughout the country. Regardless of the clearing house being used, the claim creation process is standard for all types.

Process Selection

During the claim creation process, several runtime selection options are available. Of course patient code ranges, service date ranges, and financial class selections are always available. In addition, the user may select to print all claims that need processing within the other selection criteria. They may select to "reprint" claims from history, or selections may be made to print claims that have been scheduled for reprint from the PowerView inquiry mode.

Claims Scrubbing

Prior to processing either electronic or paper claims, edit lists are processed to view any data errors that may exist for the claims. This prevents claims being processed with errors; thus, improving initial claim acceptance and quicker payment turnaround. Process error free claims the first time with this "scrubbing" process.

Tracers

Claims tracers may be printed on demand for any date, carrier, or financial class range. All claims that have not been paid within the report ranges will be printed, listing the claim details. The format of the tracer is derived from a Word template; thus, the format may be customized.