Insurance Company Paper Claims Settings

Configure Paper Claims Settings

1. Find the insurance company then click the insurance name to open. The General tab of the Edit Insurance Company window opens by default.
2. Click the Paper Claims tab. The Paper Claims settings information displays.
3. Select the appropriate settings for the insurance company.
   1. Professional Claim Format Settings section:
      • Insured Format: Leave as Default or click the drop-down arrow to select Medicare style to prevent information from printing in Boxes 4 and 7, and to print "NONE" in Box 11.
      • CMS-1500 field 24g: Leave as Units (standard) or click the drop-down arrow to select Minutes (typically only used for anesthesia related charges).
      • CMS-1500 field 32b: Click to select or clear the selection for "Use Facility ID".
        Note: When enabled, the Facility ID Number entered in the Service Location record populates Box 32b. This is typically only required if the service location has been assigned a unique Facility ID number by the payer.
      • Primary Billing Form: Click the drop-down arrow to select the CMS-1500 format that is required by this insurance company (as the primary payer on a claim).
      • Secondary Billing Form: Click the drop-down arrow to select the CMS-1500 format that is required by this insurance company (as the secondary or tertiary payer on a claim).
        Note: In most cases the same form can be used for both primary and secondary claims but confirm with the payer if there is any uncertainty.
   2. Institutional Claim Format Settings section: The Primary Billing Form currently only has one format, UB-04 Form.
4. Click Save to record any changes.