Each claim must be associated with a patient visit. To complete the Patient Information section:

1.Start typing in the patient name and select using the patient search results.
2.If the patient does not appear, click theINSYNC~1_img42icon to perform a patient look up or add a new patient.

Note: Upon selecting the Patient, the facility, provider, patient insurances, and referring Provider fields will auto-populate.

3.The Copy Previous Claim Details icon Copy_new is displayed if one or more claims are already created for the selected patient. To copy the claim details from any of the previous claims created, do the following:
•Move the mouse pointer over the Copy Previous Claim Details icon Copy_new.
•In the listed claims, click the claim number to view the claim details.
•Select the one from which you want to copy the claim details.
•Claim information such as the Additional Claim Information, UB04: Additional Institutional Claim Information, Referring Provider, CPT/Modifier, ICD Code(s), NDC, Ordering Provider, and Supervising Provider is selected by default. Deselect the items which you do not want to copy in the new claim.
•Click the Copy previous Claim Information button.
4.If the Facility, Provider, or Primary Insurance differs from that displayed, use the drop-down menus to make a new selection.
5.To perform the insurance eligibility check before submitting the charges. Click this icon Insurance_eligibility adjacent to the insurance.
6.If you would like to leave this screen and go to the Patient Insurance Details, click the patient_insurance icon next to the patient name.
7.Choose the Billing Type as either a UB04 (Institutional) claim or a 1500 (Professional) claim.

Notes:

•The UB04 functionality is applicable for both Electronic and Paper claims. Capabilities within the UB04 are currently limited and should be discussed with an InSync Support Representative before attempting to use.
•The claim scrubber can be done only when the Billing Type is selected as HCFA (Professional).
8.On selecting UB04 as billing type, 7 new fields will be displayed: Type of Bill, Type of Admission, Patient Status Code, Frequency Code, Source of Admission, Admitting Dx Code, and Attending Provider. Select the appropriate values from the drop-down list in these fields.
9.If an Authorization Number is required, click theINSYNC~1_img42 icon to find authorizations linked to that patient. You can also configure authorization details from this section, if required.
10.Enter the Payment Amount and select Payment Type using the drop-down menu.

Note: If copay has already been entered for this visit, these fields will prepopulate.

11.If copay has been collected for this visit, you can click the “Detach Copay” check box to exclude the copay amount from this claim. The money collected would then turn into an “Unapplied Credit” on the patient’s account.
12.The “Default P.O.S.” will automatically load based on the facility selected. If you need to change the Place of Service, you can do so using the drop-down menu.
13.By default, the referring provider is auto-filled as per the details maintained in patient demographics. Change the referring provider, if required.
  Note: If a referring provider is not located within the software, click the configure_icon icon to configure new referring provider.
14.Select the Billing Entity using the drop-down menu.
15.Select the Self Pay button to indicate that either this visit or patient is self pay.
  Note: “Self Pay” claims will automatically assign a Patient Responsibility Balance to the patient upon Claim Generation. They will not move to the Claims Processing queue.
16.Select the Date of Claim, if different from that displayed, using the Calender.
17.Enter any Notes into the free-form text box.