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Charge Management Rule Examples
Alert for Provider Credentialing There is a System delivered Charge Management Rule to display a Validation Warning for Providers who are not yet Credentialed with a Specific Insurance. Use this link for more detailed documentation: Hold Billing for ...
Denial Worklist Overview
A Payer Rejection is not the same as a Payer Denial. A rejection gets kicked back before it enters the Payer's system. A Denial has been adjudicated, and Payment has been denied. The Denial Worklist is populated when an ERA is applied, and at least ...
Worklist Filters
Filters Options on the Worklist screen Total By & Subtotal By: Use these filters along with the Type filter to create multiple views of the Worklist. (Worklist Total By Option below) Type: Works in conjunction with Total By & Subtotal By. Worklists ...
Charge Management Action Examples
Add a Legacy ID in HCFA Box 33b for a Secondary Payer Scenario: BCBSTX is Primary and MagnaCare is Secondary. MagnaCare wants a Legacy ID in Box 33b on the HCFA (Paper Claim), but the Primary, BCBSTX, does not require this. Details Enter Description. ...
Worklist Suggestions & Examples
Appointment Missed Appointment Fee: Added by Front Desk user for biller to add a No Show Fee. Workers Comp: Authorization missing Eligibility Denials Authorizations Encounters Manual Insurance Denials Eligibility Denials Authorizations Missing ...