Claim Section

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The Claim section allows you to to create, edit and send the claims and charges for the patients.

The following help pages are supported by the current version of CollaborateMD. Please follow the curriculum outline to receive the proper training associated with this section.

Claim

Charges

Additional Info

Insurance

Activity

Notes

Alerts

Documents

Review



Button Overview

Below you will find a description of the buttons located within the Claim section:
  • Analyze Claim: Selecting this button will analyze the claim for payer-specific and generic claim edits.
  • Review Claim: Selecting this button will allow you to review the claim.
  • View Current Report: Selecting this button will allow you to view the most current claim scrubbing report.
  • View History: Selecting this button will allow you to view the claim scrubbing history. 
  • Print Report: Selecting this button will allow you to print the claim review report. 
  • Close Report: Selecting this button will allow you to close the current open report. 

Claim Analysis

Analyze Claim 

Claim Analysis is a built-in clearinghouse edit engine that validates professional and institutional claims for Generic or Payer-Specific Edits. This feature allows you to correct claims before it’s rejected by the Clearinghouse. Analyzing your claim prior to it being sent to the Clearinghouse will save you a significant amount of time on rework. 

Follow the instructions below to analyze a claim:
  1. Go to the Claim Section.
  2. Add a new claim or open the claim you wish to scrub.
  3. Click the Review tab.
  4. Click the Claim Analysis sub-tab.
  5. Click Analyze Claim.
  6. To correct any errors that may have been found, click Fix Error. You can then make corrections to that section.
  7. When you're done correcting all errors, analyze the claim again to ensure a completed claim.
  8. When you are done analyzing the claim, click Save.

Claim Scrubbing

Claim Scrubbing helps you manage the complex rules and terminology of coding. This feature is used to analyze the claims before submission to the clearinghouse as a solution for catching problem claims, maximizing the potential for your healthcare facility to be paid correctly on the first submission. 

If you would like to enable Claim Scrubbing, please reference the following Help Page

Review Claim

Follow the instructions below to review your current claim:
  1. Go to the Claim Section.
  2. Add a new claim or open the claim you wish to scrub.
  3. Click the Review tab.
  4. Click the Claim Scrubbing sub-tab.
  5. Select Review Claim. The system will scrub your claim and provide you with a Claim Review Report.

View Current Report

Follow the instructions below to view the Claim Review Report:
  1. Go to the Claim Section.
  2. Add a new claim or open the claim you wish to scrub.
  3. Click the Review tab.
  4. Click the Claim Scrubbing sub-tab.
  5. Select View Current Report. The system will provide you with the most current Claim Review Report.

View History

Follow the instructions below to view the claim history: 
  1. Go to the Claim Section.
  2. Add a new claim or open the claim you wish to scrub.
  3. Click the Review tab.
  4. Click the Claim Scrubbing sub-tab.
  5. Select View History. The system will open up the Claim Review History. You will be able to see when the claim was last scrubbed as well as the user that scrubbed it..

Print Report

Follow the instructions below to print the claim scrubbing report: 
  1. Go to the Claim Section.
  2. Add a new claim or open the claim you wish to scrub.
  3. Click the Review tab.
  4. Click the Claim Scrubbing sub-tab.
  5. Select Review Claim or View Current Report to pull up the claim scrubbing report.
  6. Click Print Report.

Close Report

Follow the instructions below to close the Claim Review Report: 
  1. Go to the Claim Section.
  2. Add a new claim or open the claim you wish to scrub.
  3. Click the Review tab.
  4. Click the Claim Scrubbing sub-tab.
  5. Select Review Claim or View Current Report.
  6. When you are done viewing the report, click Close Report.

Errors 

The Errors tab allows you to view the Claim Review Report in a table format making it easier to read. Follow the instructions below to view the claim scrubbing errors: 
  1. Go to the Claim Section.
  2. Add a new claim or open the claim you wish to scrub.
  3. Click the Review tab.
  4. Click the Claim Scrubbing sub-tab.
  5. Select Review Claim or View Current Report.
  6. Click on the Errors sub tab. You can now see the errors in a tabled format.