Claim Defaults contain fields that are automatically carried over to your newly created claims. They can be changed at any time to a new default setting; once changed, the defaults will only take effect for newly created claims. Defaults can also be changed on a claim itself for a one-time change.
Follow the steps below to set your Claim Defaults for a specific office.
Select Customer Setup > Practices.
Use the Show All button to view all practices. Or use the Search field to further drill down your search.
Select the Practice.
Locate and click on the Defaults tab from the right-hand side panel.
Click the Claim tab.
Make your selections referencing the Claim Default Descriptions below.
Claim Default Descriptions
Default Place of Service: Click on the magnifying glass to select a default place of service.
Default Type of Service: Click on the magnifying glass to select a default type of service.
Payer Address Location on Claim Form: Click the drop-down to select if the payer address will print on the left or the right side on the claim. Note: By default, Right is selected.
Print Anesthesia start/stop time on CMS-1500 box 24: Check this box to print the anesthesia start and stop time on Box 24 (of the CMS 1500 form).
Auto decrement authorized visits on claim entry: Check this box to auto decrement the visits authorized on claim entry. This will automatically decrease the visits left once the claim is saved.
The following are Institutional Claim Defaults only.
Include accident and illness information on claims for all patients: Check this box to automatically populate the Injury/Accident date shown in the Patient section under the Claim Defaults tab on all future claims created once checked.
- Exclude the Facility when sending claims to insurance: Check this box to automatically populate the facility on claims, but exclude it when sending to the payer.
Type of Bill: Click on the magnifying glass to set a default bill type for institutional claims. It will also set a default three-digit bill type for institutional (UB-04) claims. Choose your options by clicking the drop-down on each of the following:
Type of Facility: The type of facility represents the first digit of the bill type.
Type of Care: The type of care represents the second digit of the bill type and is dependent on the type of facility.
Frequency: The frequency represents the third digit of the bill type.
Admission Type: Select the drop down to set a default Admission Type for institutional claims.
Admission Source: Select the drop down to set a default Admission Source for institutional claims.
Patient Status: Select the drop down to set a default Patient Status for institutional claims.