Create/Edit Insurance Claim
This is the screen used to create or edit an insurance claim for a patient.
The fields are as follows:
| Claim Number | the number assigned to the claim by the insurer. For claims submitted online, this will be set on submission. |
| Date | the date the when the claim was created |
| Completed Date | the date the when the claim was settled, declined or cancelled |
| Policy | the policy that the claim is for |
| Author | the user that created the claim |
| Claim Handler | the user responsible for handling the claim. If necessary, the insurer may contact the Claim Handler with queries about the claim. |
| Location | the practice location where the claim is being made |
| Clinician | the clinician responsible for the claim |
| Amount | the total amount of the claim |
| Tax | the total tax of the claim |
| Status | the current status of the claim |
| Notes | optional notes |
Conditions
The Conditions tab lists the conditions being claimed.
The fields are as follows:
| Claim Number | the number assigned to the claim by the insurer. For claims submitted online, this will be set on submission. |
| Treatment Start | the date that treatment for the condition commenced |
| Treatment End | the date that treatment for the condition ceased. If the condition is ongoing, this represents the last date when treatment for the condition was given to the patient, within the practice. |
| Amount | the total amount of charges being claimed for this condition |
| Tax | the total tax on the charges being claimed |
| Status | the status of the condition |
| Notes | a synopsis of the the condition being claimed |
| Charges | the charges being claimed for the condition |
Conditions can be added using:
|
Adds a Condition that requires the user to fill in all of the fields manually |
|
Adds a Condition where the fields and the charges are filled in automatically from the selected Visit |
|
Adds a Condition where the fields and the charges are filled in automatically from the selected Problem |
Attachments
The Attachments tab lists the attachments that will be submitted as part of the claim. These are a copy of the original documents, taken when the claim is submitted.
To see what documents will be attached, click the Generate Attachments button.
The following attachments will be automatically added:
- Patient History - the full patient history up to the time of the claim
- Customer Invoice - an invoice will be added for each invoice referenced by the claim
History
The History tab displays the patient history, and is provided to help construct the claim.
It does not represent the history that will be attached to the claim when it is submitted.
