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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Case and Encounter

Case and encounter are co-related and relates the patient insurance (Patient himself)to each bill items ( 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. The following are the details provided in the Encounter Lines. Field Description CPT Code The CPT codes used for this particular encounter will be listed […]

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Appointment Color Codes in the Charge Entry Screen

Below is a sample screenshot of the appointment view in the Charge entry screen. Color categorization helps to easily identify the charge status and to locate an unposted charge. The below table gives a brief description of each color code shown above. Color Description Indicates that no charge has yet been created against the appointment. […]

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Hold Charges

Charges can be put on hold in two ways. Unposted charges can be put on hold from the charge entry screen. Posted charges require charge master to put them on hold. 1. To put unposted charges on hold from the Charge Entry screen, select the Charges module from the left side menu and click on […]

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Add Notes for a Charge

Any additional notes or comments on a claim can be entered from the charge master screen. 1. To enter a Line Note (Procedural Level note), click on the note icon on the encounter line which opens up the field to enter the line note. 2. Enter the note in the field provided and click on […]

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Enter Anesthesia Time

To enter Anesthesia time of a procedure, click on    icon on the encounter line. On the box that pops up, enter the Anesthesia time. The time should be in HH: MM format, click Save & Close to save the info.      

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Override the line Status

Insurance claims can be overridden to bill individual lines to the patient or to write them off. The Override drop-down in each line in the charge entry screen is used for this purpose. By default, Override has the value ‘None’ meaning that there is no override for the line and the line is set to […]

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Add a new patient from Charge Entry

To add a new patient from the charge entry screen, select the Charges module and click on Enter Charges from the left side menu. Click on  button and then click on the   button next to Patient search. Patient Information screen pops up as shown below. Enter all the required fields and click on Save.

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Enter charge with a different Service Location/Facility

Place of Service and Service location in the charge entry screen populates from the corresponding fields provided in the Billing Options page of the Practice. In order to change the Place of service and service location during charge entry, follow the below-given steps. 1. Select Charges from the main menu and click on Enter Charges. […]

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