Guidelines for Filling HCFA Form

Table 1 explains each of the boxes in the HCFA Form Field # Field Name Field Description/Instructions 1 Coverage PAYER TYPE of the destination payer. The type of health insurance coverage applicable to this claim by checking the appropriate box. 1.a Insured’s ID Number List the Insured’s identification number entered in the subscriber# field of […]

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UB04 Charge Entry

UB04 Charge Entry screen manages the entry and edit of UB04 charges. Some key points related to UB04 Charge Entry are: 1. UB04 charge entry is used for institutional claims only. 2. There is no mapping between CPT codes and diagnosis. 3. Revenue codes are mandatory, whereas CPT codes are not. Shown in Image 1 […]

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X-Superbill

X-Superbill is used for charge entry of bulk data. Billing of multiple patients can be done with the X-Superbill screen, simultaneously saving the records into PracticeSuite. Below is a sample screenshot of the X-Superbill screen. Image 1 1. Search Charges (Section 1 in Image 1): The highlighted section numbered 1 in Image 1 is used […]

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CPT Groups

A CPT group is a collection of CPT codes that are often used in conjunction. When the group code is entered in the CPT field, all the CPTs in the group along with their amounts get populated in the respective fields during charge entry. Thus, the creation of a CPT group aids in error-free and […]

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Claims Dashboard

Claims Dashboard provides detailed information on every claim generated in the system. The dashboard has a pie chart representation to get a quick view of the number of claims in the different statuses. Image 1 is a sample screenshot of the dashboard. Image 1 The left pane shows the different buckets (that represent the various […]

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Common Clearinghouse Rejections – TriZetto

Common Clearinghouse Rejections (TPS): What do they mean? Rejection Message Payer Rejection Type Information MB – Subscriber and Other Subscriber Claim Filing Indicator Codes cannot both be MB. 2320.SBR*09 Not Payer Specific TPS Rejection What this means: The primary and secondary insurance on this claim are both listed as Medicare plans.  This is not valid. Provider […]

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Enter Charges

The charge entry process is the initial and one of the crucial stages in the billing cycle. To access the charge entry screen, Select Charges from the main menu and click on Enter Charges. This article explains the different fields in the charge entry screen. Image 1 is a sample screenshot of the charge entry […]

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Case and Encounter

Case and encounter are co-related and relates the patient insurance (Patient himself)to each bill item ( Encounter). Hence you can find the case and encounter listed in Edit charges. From the Main Menu, select Charges and click on Edit charges to open the Edit charges page. When the Edit charge page opens up, click on […]

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Encounter Lines

Encounter Lines displays the different Procedures associated with an Encounter, DOS start and End Dates, the related diagnoses, the Charges, and Total Amount, Adjustment Amount, Claim Status, Accounting date, etc. Refer to Image 1. Image 1 Table 1 describes each field of the Encounter Line in detail. Field Description CPT Code The CPT codes used […]

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Edit Charges (Charge Master)

The charge master/ Edit charges screen is the primary screen for editing of charges. It displays the list of Encounters grouped by cases for the selected patient. For each encounter, the list of diagnosis codes, the procedure codes and their corresponding charges, Billed amount, Paid amount, current status, etc., are displayed and can be edited […]

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