How to set POA indicator in Institutional Claims?

Method 1: This sets the POA field of a single claim. User can enter a text POA in the Remarks field of UB04 Charge Entry that will populate the POA. Method 2: This updates the POA field of all claim sent to a specific payer or for all payers. EDI has a rule that will […]

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How to Show Delay Reason in Institutional Claims?

Enter the Delay reason code in UB04 charge entry screen column 80 “Remarks” as follows and the system will map accordingly in the EDI. DELAYCODE-<code> Valid codes are 1, 2, 3, 4, 5, 6, 7,8, 9, 10, 11, 15 Description for each delay code is available in the URL “http://www.reliablehealth.com/P3162.htm”

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How to Send Patient SSN on EDI claim file?

To send Patient SSN in the Claim: 1)  Go to Charge Master (Edit Charges screen) and navigate to the Encounter section. 2)  Move to Details tab and then click on the Others tab inside it. 3)  In the Claim Note/Special Instruction field, enter the SSN in the below given format. “SSN-<<ssn number>>” eg:  SSN-123456789 4)  […]

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How to Send ESPDT Information on EDI Claim?

Click the “EPSDT” check box in Charge Entry/Charge Master screens. On the Claim Note, specify the Condition Indicators. The format should be: EPSDT:<condition indicator code> e.g. EPSDT:AV Table 1 displays the valid Condition Indicators Condition Indicator Code  Description AV Available NU Not Used S2 Under Treatment ST New Services Requested

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