This will show you how to enter Claims manually which is especially helpful for those clients not using In Touch EMR to document the encounter, or when you need to create a claim and are maintaining documentation in another format.
If you are currently not using In Touch EMR for documentation, you will need to enter charges manually within In Touch Biller Pro.
If you would like more information about In Touch EMR; and how it is integrated with In Touch Biller Pro, please contact our support team at firstname.lastname@example.org.
To begin entering charges manually:
- From the Dashboard, click on “Create Claim” under Claims.
Locate the patient you are entering charges for.
- Identify the patient and locate the chart number
- Find the associated Appointment of the patient on the list
Then choose from the list of existing appointments for that patient, by clicking on the blue date on the left side. You will be creating a claim for that appointment.
It is not necessary to select a pre-existing appointment to create a charge, you can also hit “Proceed to Charge Entry” highlighted in blue above the appointment list.
- Create a claim
You are now at the Create Claim (CMS 1500) screen. Clicking on any entry under Time, will open the “Create Claim (CMS 1500); Charge Entry” screen.
- ICD10 on Charge Entry
In preparation for the eventual ICD10 transition, an ICD9/ICD10 option has been added in Charge Entry. This allows billers to toggle back and forth between ICD9 and ICD10 codes and descriptions when performing code searches or panel lookups. To help billers prepare, User Hold claims may be created using ICD10 codes however claim validation prohibits the final claim creation.
- Charge Entry
The charge entry screen contains relevant billing and insurance information on the patient. The Diagnosis Code(s) section of this page allow the biller to enter the ICD codes as well as any CPT codes that apply to this patient’s visit.
The charges will auto-populate once the codes are entered in according to your fee schedule.
Payer Claim Rules
The following Payer claim rules have been implemented to help prevent claim rejections:
- Medi-Cal claims are no longer limited to 6 service lines
- USAA claims now require an Accident Date
- First Health Network requires an Insured Group Number
- Claim Frequency Codes “7” and “8” require an Original Reference Number
- Claim Frequency Code cannot be “6”
- If Claim Frequency Code is “1,” the Original Reference Number will not be allowed
- For Medicare Part B, the Claim Frequency Code must be 1
- The user will receive a warning for $0.00 service lines for all payers except Medicare and Medicaid
- ChampVA and Tufts Patient Relationship must be “Self”
- Date of Current Illness cannot be equal to or greater than the Date of Service
- A Referring Provider will be required if a Referral Number is present
- If the Payer Type equals “BlueCross BlueShield” and the Insured ID starts with “R0” through “R9,” the length must be 9 characters
- If the Payer Type equals “BlueCross BlueShield” and an Accident Code is used, the Accident Date will be required
Recently, a new feature was implemented to automatically print the NDC number in box 24K. Now, per NUCC guidelines, the “NDC” will be replaced by the N4 qualifier. In addition, the EDI qualifiers for the unit of measure will print along with the actual number.
- UN Unit
- F2 International Unit
- ML Milliliter
- ME Milligram
- GR Gram
Print Date Qualifiers on New CMS Form
Per NUCC guidelines, the proper qualifiers have been added to box 14.