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- Here are some related articles in Manage and Administer Your PCC Tools > Configure Partner and Billing Functions > Add and Configure Insurance Companies > Front Desk > Edit Patient Insurance Policies:
- When insurance carriers send payment and adjustment information, either on an EOB or an ERA, they often include a code with a small message. These codes are known as CARC values, or Claim Adjustment Reason Codes, and they are an industry-wide standard.
- Every insurance claim in Partner has a unique identification number. The number appears in various Partner reports and programs, and you can use it to improve claim tracking and payment posting.
- Follow this procedure to prepare and send claims.
- Partner's insurance billing tools help submit claims, review rejections, and work down your insurance accounts receivable. Partner helps you maximize the use of your time as you pursue proper insurance reimbursement.
- You can review and confirm patient insurance eligibility in either PCC EHR or in the Partner practice management system. This article teaches you how to use Partner's eligibility program to review status for upcoming appointments.
- Hopefully most of your claims are submitted electronically. Some claims must still be printed on paper, however. The procedure above provides the basics. This section describes additional details and options in the
- How is a claim created, and what happens in the background to make sure your practice is paid? Read below to learn some of the "under the hood" workings of claims after you post charges into PCC EHR.
- PCC automatically checks insurance eligibility for all of a scheduled patient's active insurance plans, if the carriers support automated eligibility. You can use eligibility features in PCC to review and confirm eligibility for upcoming appointments. You can also review and re-check a patient's insurance eligibility status during Patient Check-In.
- Use policylog to research past changes to a patient's insurance policies.
- In addition to updating insurance polices in the patient's record in PCC EHR, you can also edit policy information for a patient in the Partner, Practice Management system.
- The Policy Log (
policylog) program displays a log of all changes made to a patient's insurance policy record.
- Families bring in new insurance cards all the time, particularly if you are a new client or if it is January. While taking time to add and configure a new plan in Partner is important, many new insurances can be added quickly and easily.
- This article is a reference to the Insurance Companies table and the Insurance Groups table, both of which are in the Table Editor (
ted). They contain information about the insurance policies in your system, and they effect billing and reporting.
hedfeprogram is a HCFA/CMS 1500 form editor. It can configure both the layout and the content of claim forms. You can use the program to move form data around or change how it is filled out. Simple errors on claim forms can delay payment and cost your practice both time and money. Therefore it is important to understand how Partner fills out HCFA forms and how to make changes to your forms when necessary.
- Do you need to replace all of a provider's identifiers with a different provider's values? Can Partner change a provider's name or Taxonomy code on some claims, or include a custom insurance eligibility ID#? How do you configure the legacy PIN and Group numbers required by some carriers? Partner's Provider IDs (
provids) program allows you to override any claim identifier information. Use
providsto set an alternate provider, or to enter custom values for the name, Taxonomy code, NPI, Tax ID, eligibility, or legacy ID numbers.
- Tricare North and Tricare South are merging into a new entity: Tricare East. If your practice wishes to submit claims to military families who were on Tricare North or Tricare South, you must become credentialed and enroll for electronic claim services, eligibility, ERAs, and optionally electronic funds transfer.
- Use the "Policies" component to add, update, and work with a patient's insurance policies and medicaid plans in PCC EHR.
- Learn how to review, update, and edit policies in PCC EHR.
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