Centralized Claims Management

PracticeStudio's Claims Management folder categorizes claims by their status—Queued Claims, Claim Exceptions, Claims with Ineligible Transactions, and Claims History—and displays a wealth of information about each claim listed, all on one grid:

• Claim number
• Date the claim was queued
• Status (Queued 837, Queued CMS, Errors, Sent, Complete, Void, Deleted, etc.)
• Number of days at the current status
• Patient name, code, financial class, incident, and provider
• Carrier, including Primary or Secondary notation
• Total amount billed on the claim
• Security user to whom the claim is assigned
• Scrubbing errors, as well as details about how to resolve them
• Transaction service date, CPT code, Dx codes, Narrative text, and NDC number

Perform Quick Claims Tasks

• Find a specific claim quickly and easily by typing in the claim number or selecting a recently accessed claim from a list of Most Recently Used records.
• Sort displayed claims by patient, provider, carrier, claim type, financial class, status, and more.
• View all claims containing scrubbing errors on a single page, access those errors, and edit claim information as needed.
• View claim information on a preview CMS 1500 form.
• Queue claims:
  • Specify the amount of time that must have elapsed since a transaction was posted before it will appear on a claim.
  • Produce multiple claims for the same patient, grouped by transaction date.
  • Attach free-text notes (which can be formatted using a Rich Text Format toolstrip) to any claim.
  • Re-queue unpaid service lines so they can be resubmitted, with or without editing them first.
• Modify existing claims:
  • Manually edit any of the existing information on a claim or add information to any blank field.
  • Re-compile claim information by gathering patient and transaction details again from the PracticeStudio database.
  • Split transactions appearing on one claim into two separate claims.
  • Combine multiple claims for the same patient, incident, carrier, subscriber, and provider into a single claim.
• Submit claims in 2 different formats: 837 (electronic) or CMS 1500 (paper).
• Override automatic claim tasks:
  • Suspend billing activity—for a user-defined amount of time—for patients who have been admitted to a hospital.
  • Ignore scrubbing errors and force a claim to queue.
  • Place individual claims on hold so they cannot be submitted.
  • Dismiss past due claims for a specified length of time, after which you will once again be notified of them.
• Assign the tracking of certain claims to specific security users:
  • Specify when claims will be assigned to a user: when queued, when they have scrubbing errors, when placed on hold, when denied, or when they become past due.
  • Assign claims associated with specific financial class(es), provider(s), clinic location(s), carrier(s), or patient(s) to different security users.