Contract Validation Claim Selection
Use this process to select a claim to validate.
Procedure
- Access the Contract Validation Claim Selection page.
- Select Go To > Contract Loading > Support Functions > Contract Validation. The Contract Validation Claim Research page opens.
- Type an account number, and then click Display Claims. The Contract Validation Claim Selection page opens.
- Select a claim, and then click Select Claim. The Contract Validation Criteria page opens. For more information, refer to Contract Validation Criteria.
- If the account only has one claim, that claim will be the default selection.
- Optionally, you may click a link in the following columns:
- Claim Type to display the claim representation. For more information, refer to View the UB-92 Representation or View the 1500 Representation.
- Account Number to display more details on the Patient Account Audit page. For more information, refer to View the Patient Account Audit Page .
- Message Code to display the message description.
Field DescriptionsThe following table describes the fields on the Contract Validation Claim Selection page.
Field | Description |
Account Number | Patient account number (for UB claims) or insured ID (for CMS-1500 claims) |
Admit Date | Date of admission for the account |
Bill Type | Bill type |
Claim Type | Claim type, UB or HCFA |
Billed Charges | The total charges incurred for the claim or set of claims that have been repriced |
Message Code | Message code; may be a link to the code description |
Patient Type | Patient type assigned to the account: Inpatient/Outpatient |
Payor Code | Payor code associated with the product |
Service From | First date of service rendered to the patient |
Service To | Last date service rendered to the patient |
Submit Date | Date the claim was submitted |
Links on the Contract Validation Claim Selection Page- Claim Research displays the Contract Validation Claim Research page. For more information, refer to Contract Validation Claim Research.