The claim process is cyclical. For every claim period the following steps need to be taken:
- Ensure the errors in the previous claim have been investigated and fixed.
- Receive all signed phone, fax, and referred scripts.
- From the main menu go to 4. Electronic claiming and select 5. Check phone/fax/refer Rxs.
- Enter the required date range and press F12 Accept Details.
- Press F2 Edit Rxs.
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To receive scripts, use the function keys or scan the barcodes.
- Press F12 Accept Details twice to save the changes.
- Create the claim.
- From the main menu go to 4. Electronic claiming, 1. Edit claim, and press F3 New Claim.
- Enter the required claim dates (1- 7, 8-15, 16-23, or 24 to the end of the month if doing weekly claiming) and press F12 Accept Details.
- Defer all outstanding tel/fax/referrals and uncollected (if collection status tracking is turned on)
- Press F2 Edit Claim then F4 Status.
- Select Phone/Fax/Refer/Uncollected Rxs - Defer options and/or Scan/defer Rx in bulk.
- Press F12 End Edit.
- See Claiming: Deferring Uncollected Scripts.
- Error check and fix any claim errors.
- Press F11 Error Check.
- Use the function keys, F7 Find Next, F8 Find (in particular Error Rx (Down) and Find Error Rx (Up)), and F9 Fix to help find and fix any errors that might stop the item from claiming correctly.
- Press F12 End Edit.
- Save and send the claim.
- Press F11 Send Claim and accept the prompts.
- Press F12 Save Claim.
- Get the reply file and fix any errors before the next claim is created.
- From the main menu go to 4. Electronic claiming, 1. Edit claim, and select the most recent claim, with the Status of Sent, by clicking on it.
- Press F3 Load Reply.
- It will prompt if the reply file is not yet available.
- Fix the errors shown in the last column Reply/Error:
Reviewed: 09/12/2024
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