Specify a Claim to Override

If your facility uses the online claim override function, and if you are authorized to do so, you can change existing claim data online.

Use this procedure to select a claim to override.

  1. To access the Add Claim Override page, select Go To > Overrides > Add Claim Override.
  2. Type the number of the account you want to override in the Account Number field.
  3. Select the type of value you want to override from the Field Types list.
    • Select Bill Type for claim replacement or claim compilation.
    • Select Payor Code to change the payor code for a claim.
    • Select Payor Code (Secondary) to change the payor code for the secondary payor. This option is only available if Coordination of Benefits is enabled for your facility and the account has a secondary payor. For more information about COB, refer to Coordination of Benefits.
    • Select Payor Code (Tertiary) to change the payor code for the tertiary payor. This option is only available if Coordination of Benefits is enabled for your facility and the account has a tertiary payor.
    • Select Payor Name to change the payor name for a claim.
    • Select Service From Date or Service To Date to change claims that have the same patient account number and admit date.
    • Select Status to change a claim’s status if the status is currently set to Normal, Secondary or Replaced.
    • Select Submit Date to change the claim’s submit date and rearrange the charge compilation hierarchy.
    • Select Void Claim to void a claim that adversely affects claim adjudication. You might also need to change the status of another claim in order for the claim to process.
    • Select Discharge Status to override the discharge status on a claim.
  4. Click Display Claims. A list of accounts displays.
  5. Select the account you want to override in the Select One column.
  6. Click Add Claim Override. The Claim Override Verification page opens. For more information, refer to Add Claim Override Data.

The following table describes each of the fields on the Add Claim Override page.

Field

Description

Account Payor Code

Account payor code for the account

Admit Date

Date of admission for the account

Bill Type

Bill type

Billed Charges

Total charges for the account

Claim Payor Code

Claim payor code for the account

Claim Payor Name

Name of the payor for the claim

Discharge Date (Service To)

Discharge date

Entry Date

Date the claim was entered into Contract Manager

Field Type

The type of override to search for

Message Code

Description of the message code

Patient Number

Patient account number (for UB claims) or insured ID (for CMS-1500 claims)

Select One

Allows you to select the claim to override

Service Start Date

Date service began

Submit Date

Date claim was submitted