Submit a Reimbursement Claim

Use this tutorial to submit a new Reimbursement claim.

Complete the following steps to Submit a Reimbursement Claim:

Select the Enter A New Claim menu option on the Provider Services menu. The Enter a New Claim page displays.
Complete information in the following controls to specify the authorization identification number and the client date of birth for the claim, and to select the type of claim:
In Authorization ID, enter the specific authorization identification number for the claim.
In Client Date of Birth, enter the date of birth of the client for which the claim is to be entered.
In Claim Type, select Reimbursement as the type of claim to enter.

NOTE: You can click Authorization Search to search for an authorization as necessary. When clicked, the page refreshes and displays Authorization Search functionality. Complete information in one or more of the following controls to search for an select an authorization:

In Authorization ID, enter the specific authorization identification number on which to search.
In Authorization Date, enter a specific date to search for authorizations active as of the date specified.
In Client Number, enter the specific client identification number on which to search.
In Level Of Care, select the level of care on which to search.
In Initiative, select the initiative on which to search.
As a provider, the name of your provider agency is automatically selected in the Provider Agency drop-down list. This information is read-only and cannot be changed.
In Provider Site, select the name of the provider agency site on which to search.

Click Search to perform a search based on the search criteria specified. The page refreshes and results found to match the search criteria are displayed in the Authorizations table. Click the Select link to select an authorization. When clicked, the page refreshes and the Authorization ID of the selected authorization is entered in the Authorization ID field under Claim Information.

Click Enter Detail to enter claim line item information for the claim. The page refreshes and displays Claim Detail information.
In Service Date, enter the date on which the service was performed for the claim line item.
In Service Package, select the service package associated with the service that was performed for the claim line item.
In CPT Code, enter the CPT code for the claim line item. Up to 50 characters may be entered.
In Amount, update the total amount claimed for the claim line item.
In Clinician, select the name of the first clinician that performed services for the claim line item.
In Secondary Clinician, select the name of the second clinician that performed services for the claim line item.
Click Add Claim Line. The page refreshes and the information entered for the claim line is added to the Reimbursement Claim Lines table.

NOTE: You can repeat steps 4-10 to add additional line items for the claim as necessary.

Once claim line item information has been added, you can update it as necessary by clicking the Edit link in the Reimbursement Claim Lines table for the specific claim line. For more information, see Update a Claim Line Item.

Click Check Claim to check the claim and verify that the information entered is accurate. The page refreshes and the Claim Number field is updated to display CHK in the claim identification.
Click Submit Claim to submit the claim. The page refreshes and a message displays under Claim Detail indicating whether the claim was submitted successfully.

NOTE: Once Submit Claim has been clicked and the claim has successfully been submitted, you can click Correct Claim to update the claim line items as necessary. When clicked, the page refreshes and the Edit link is enabled in the Reimbursement Claim Lines table.

Click the Edit link in the Reimbursement Claim Lines table to update the claim line item information. When clicked, the page refreshes and the claim line item information is populated in the fields under Reimbursement Claim Line Entry. You can complete the following tasks as necessary:

Update the information displayed under Reimbursement Claim Line Entry and click Update Claim Line to update the claim line item information as necessary. When clicked, the page refreshes and the claim line item information is updated in the Reimbursement Claim Lines table.
Click Void Claim Line to void the claim line item as necessary. When clicked, the page refreshes and Yes is displayed in the Is Void column of the Reimbursement Claim Lines table.

Click Cancel Edit if you do not want to update or void the claim line item.