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The Plan Maintenance - General tab maintains basic name and address information about a plan.
Plan is Generic
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Indicates if the plan is a "generic" plan that is used for low volume plans where a contract is not in place. When a generic plan is entered in demographics, the user should select the specific carrier so that electronic claims may be sent for the plan.
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Lookup
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Lookup value
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Name
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Description
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Plan Type
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Type of Plan (Medicare, Medicaid, etc.)
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Carrier
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Carrier name for the plan. Used for reporting purposes.
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Claim Filing Office - HCFA
Same as Carrier
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Indicates that the plan address is the same as the carrier and there is no need to replicate it here.
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Name
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Plan name for address purposes
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Address
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Address consisting of:
The tab order will skip from Street Address (Add'l) to the Postal Code. The Postal Code lookup will complete the City and State. In addition, the Postal Code lookup will default the Area Code of the telephone numbers if the Area Code is defined in Postal Code Maintenance.
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Country
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A foreign country may be entered if needed.
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Phone
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Main telephone number.
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Fax
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Fax telephone number
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Phone Other
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Other telephone number
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Claim Review Office - HCFA
Same As Carrier
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Indicates that the plan address for claim reviews is the same as the carrier and there is no need to replicate it here.
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Name
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Plan name for address purposes
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Address
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Address consisting of:
The tab order will skip from Street Address (Add'l) to the Postal Code. The Postal Code lookup will complete the City and State. In addition, the Postal Code lookup will default the Area Code of the telephone numbers if the Area Code is defined in Postal Code Maintenance.
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Country
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A foreign country may be entered if needed.
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Phone
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Main telephone number.
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Fax
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Fax telephone number
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Phone Other
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Other telephone number
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Policy Number Edit Mask
Policy Mask
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Mask that is used to enforce policy number structure rules such as number of characters, which characters are alphabetic, alphanumeric, numeric, etc.
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Examples Button
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Displays examples of how masks may be used
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Default Policy Number to Patient Social Security No
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If you would like the Policy Numbers for this Plan to default in Demographic Entry to the Patient's Social Security Number, select this option. This is useful on payors such as Medicare that utilize the SS# as part of the Policy Number. For payors that do not utilize the SS# as part of the Policy Number, it is more helpful to leave this option un-checked so that the Policy Number is blank, instead of being defaulted to the SS#.
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Require Group Number
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Indicates if the group number will be a required field for this plan in Demographic Entry.
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Require Group Name
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Indicates if the group name will be required will be a required field for this planin Demographic Entry.
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Electronic Pre-pend
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The contents of this field will be added to the beginning of the policy number on claims sent electronically for the Plan.
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Contact
(Blank)
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Enter/Select the Contact Name
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Phone
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The Contact Phone is displayed
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Address
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The Contact Address Line 1 is displayed
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User Defined Fields
If these user-defined fields are set up, they will appear in the Demographics - Insurance tab with the field tag or label defined here.
UDF 1 - UDF 4
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User-defined fields 1-4
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Req
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Indicates if the associated UDF will be a required input field in insurance demogaphics
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Miscellaneous
Display Unspecified Diagnosis Warning
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Indicates whether unspecified diagnoses (as indiicated by the Unspecified flag being set on the Diagnosis Setup) will display a warning message in Visit Entry indicating that the payer may not pay claims with unspecified diagnoses.
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