Resource Center


Configure Claim Settings

The Claim Generation settings provide various options to make the claim generation simpler and faster by configuring the default values.

Go to the 'Billing-Claims > Claim Settings' section to configure the settings.
Claim Settings Option

The options are briefly explained below, as shown in the screenshot.
Claim Settings

(1) Diagnosis Re-ordering - Choosing the option 'Yes' enables Dx codes re-ordering in both Invoice and Claim.

(2) Add/Delete Diagnosis - This option controls the addition and deletion of Dx codes from the claims.
Claim Settings

(3) Secondary Claim Processing - To configure whether the Practice prefers to process the secondary claims before billing the Patient. This affects various reports, Patients, and insurance balances as well.

(4) Automatic Claim Generation - Select 'Yes' to enable automatic claim generation when an invoice for an encounter gets approved.

(5) Claim Primary Insurance selection - To configure the insurance to be selected as the Primary insurance in a claim

(6) Claim Secondary Insurance selection - To configure the insurance to be selected as the Secondary insurance in a claim

(7) Rendering Provider - Choose the Provider to be populated as the Signature Provider(box #31)

(8) Procedures - Choose whether to add all the procedures from the invoice (or) exclude the non-covered services.

(9) Billing Provider - You can select either one Billing Provider to populate all the claims generated across the Practice or choose a specific Billing Provider for each Facility.
Claim Settings

(10) Service Facility - Decide whether to select the Facility of the encounter (or) choose any one Facility, always.

(11) Prior Authorization/CLIA # Preference - When both Prior Auth # and CLIA # are configured, which one is preferred to populate in the claim.

(12) Prior Auth # Selection - Option allows the system to decide one prior auth # out of the multiple prio auth #'s added to a Patient's insurance.

(13) Referring Provider - Set up whether to choose the Patient's Referring Provider (or) any specific Provider in all claims generated across the Practice.

(14) Release medical information - Decides whether to take the value from the respective Patient's insurance (or) a specific value(Yes/No) in all the claims.

(15) Assign medical benefits - Select whether to read this value from the Patient's insurance (or) any other default value from the list.

(16) Accept Assignment - Select the default value to be populated in all claims to indicate whether the Provider accepts the benefits under the terms of the payer’s program.

(17) Amount Paid - Choose to fill in the payment added to the invoice (or) leave it blank.

(18) E-claim Submitter Type - Choose whether to select an individual consulting Provider (or) the claim Facility as the default submitter.

(19) Pay-to Address - Choose the default Pay-to Address to be populated in all the claims across the Practice (or) set up one Pay-to Address for each Facility.