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The Practices - Claims tab is used to indicate certain claims controls for the practice.
Claim Sorting
The tab contains two lists, "Unused" and "Sorted". The Unused list contains fields that may be used for claim sorting, while the Sorted list contains the fields that are currently being used for claims sorting. The fields in the Sorted list may be arranged by the user into the sequence that the claims will be sorted in.
Claim Control
File Zero Fee Charges on Claims
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Indicates whether or not zero dollar charges will be reported on claims or suppressed. If un-checked, the "main" anesthesia charge of an anesthesia case will not be suppressed. In addition, the first charge of a non-anesthesia encounter will not be suppressed. Any other zero dollar charges will be suppressed on anesthesia and non-anesthesia encounters.
NOTE: If the main anesthesia charge is overridden to zero, the Claim Audit report will produce a warning. If the first charge of a non-anesthesia encoencounterter is overridden to zero, the Claim Audit report will produce an error.
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Assign Claim No. Prefix
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Indicates if you wish to assign a practice-specific prefix to claim numbers as the ANSI 837 files are created. This prefix can be used to identifiy claims coming from one practice vs. another or from MedSuite vs. an old system during the transition period to MedSuite.
Ths prefix is not stored in the MedSuite Billing Table and should not be entered with the payment.
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Claim No. Prefix
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Prefix to be assigned to claim numbers for the practice.
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Default Payment Status Values
Zero Balance Claims
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Indicates what the payment status should be set to when an insurance payment causes the balance of a claim to go to zero.
Allowable values are:
| • | Blank - Do nothing allow any other defaults or manual override to occur |
| • | Paid - Default to the next level of processing. This may produce a secondary claim with no amount due |
| • | Held - Hold the claim open at the current level |
| • | Self - Proceed to the self-pay level. Does no produce a secondary claim. |
Defaulting of the payment status only occurs on open claims. If a claim has been previously closed, this default will not occur.
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Credit Balance Charges
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Indicates what the payment status should be set to when an insurance payment causes the balance of a charge to go to below zero (credit balance).
Allowable values are:
| • | Blank - Do nothing, but any other defaults or manual override to occur |
| • | Paid - Default to the next level of processing. This may produce a secondary claim with no amount due |
| • | Held - Hold the claim open at the current level |
| • | Self - Proceed to the self-pay level. Do no produce a secondary claim. |
Defaulting of the payment status only occurs on open claims. If a claim has been previously closed, this default will not occur.
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