Manual Entry

The Manual Entry tool provides information about a service type and indicates a processing action. You typically use this tool when you cannot define the reimbursement details.

  • In Note, type complete reimbursement details so that you are not required to refer to the contract document.
  • In Note and Prompt, check spelling and grammar.
  • Typically, the Processing action is Flag for review, unless otherwise specified by a client.
  • Type a Prompt that is clear and concise, since it is displayed with the contract profile.

The following table describes the fields on the Manual Entry reimbursement tool.

Field

Description

Note

Detailed information that is not displayed with the contract profile

Processing Action

How the claim is handled:

  • Flag for review–Flags the claim, assigns message code 0004 to the claim and places the claim on the Exception Worklist
  • Stop Calculation–Stops calculating the claim and assigns message code 0003 to the claim. The Claim Master table is updated with the claim data, but the Bill Master table is not

Prompt

Message displayed with the contract profile–typically the reimbursement instructions