HCFA Claims (United States) |
  
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Entering a HCFA Claim can only be completed after the initial set up of SYSTEM > HCFA PARAMETERS has been completed.
To edit an existing HCFA Claim, enter the HCFA Claim Number or use the search tool to find your patient and claim number. To edit the selected HCFA Claim, click the CHANGE icon and proceed with editing.
To add a new HCFA Claim, click ADD. A new HCFA Claim number will populate. Press your ENTER key to accept.
You may be prompted to select either ICD 9 or ICD 10 format. Make your selection and then press OK. The parameter to select a default selection of ICD 9 or ICD 10 or be prompted to select with each new claim can be edited within CONFIGURE SYSTEM SETTINGS > SYSTEM > HCFA PARAMETERS.
The DOCUMENT DATE will default to today. Accept today's date by pressing ENTER to go to the next field or edit the date as needed.
Enter the patient for this HCFA Claim. To search for a patient use the search icon and complete the search criteria. Otherwise, simply enter the patient number directly or the beginning of the patient's last name. Certain information on the HCFA Claim will populate automatically based on the information stored in their patient information file.
The screen prompts are:
Section 1 - Check which insurance option applies.
Section 2 - The patient's name information populates here.
Section 3 - The patient's birth date and gender populates here.
Section 4 - The Insured name information populates here. (Or patient name information if no insurer is indicated.)
Section 5 - The patient's address information populates here.
Section 6 - Indicate the patient's relationship to the Insured.
Section 7 - The Insured's address will populate.
Section 8 - Indicate the Patient's marital and employment status.
Section 9 - Other Insured's Name information will populate here.
Section 10 - Indicate the factors the Patient's condition is related to.
Section 11 - Indicate the Insured's Policy Group or FECA Number, date of birth, gender, name or school name, insurance plan name or program name and indicate whether there is another Health Benefit Plan.
Section 12 - Signature information regarding the release of medical information.
Section 13 - Insured's or authorized person's signature for payment of medical benefits.
Section 14 - Enter the date of current Illness or Injury or Pregnancy if applicable.
Section 15 - Enter first date of same or similar illness if applicable.
Section 16 - Enter dates Patient unable to work in current occupation if applicable.
Section 17 - Enter the name of the referring Provider or other source. Also indicate the NPI information if applicable.
Section 18 - Indicate any hospitalization dates related to current services if applicable.
Section 19 - Reserved for local use if applicable.
Section 20 - Indicate whether this claim is outside a lab and the charges if applicable.
Section 21 - Indicate the diagnosis or nature of illness/injury from the drop down ICD Codes. (Which are maintained in ICD Codes (United States only).
Section 22 - Indicate Medicaid Resubmission information if applicable.
Section 23 - Indicate a Prior Authorization Number if applicable.
Section 24 - Indicate each service provided with a check box at the start of the line and complete the details of the service as applicable. Up to 6 items/services can be performed on 1 HCFA Claim.
Section 25 - Indicate the federal tax ID number if applicable.
Section 26 - Populates with the patient number.
Section 27 - Indicate whether you accept assignment if applicable.
Section 28 - The total charges will appear here if applicable.
Section 29 - Enter the amount paid if applicable.
Section 30 - The balance due on this HCFA Claim shows here if applicable.
Section 31 - Indicate the Specialist and date for this HCFA Claim.
Section 32 - Indicate the service facility location information.
Section 33 - Indicate the Billing Provider Information.
At the top of the screen under DOCUMENT DATE is the READY TO SUBMIT box. When the claim is complete and ready to be exported, click the READY TO SUBMIT box. This will make it available to export.
To print your HCFA Claim, click PRINT.
Click SAVE to save the HCFA Claim.