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Claim edits tab

Suggest edit Updated on April 26, 2021

The Claim Edits tab lets you configure specific edits that can be used against a claim being processed. Claim edits are defined by claim type.

Once you open a claim, additional parameters for claim edits at the Claim Type level are:

  • Billing – Indicates whether claims are processed for billing purposes.
  • Reporting – Indicates whether claims are processed for reporting purposes.
  • Processing – Indicates the level of processing for payment of claims (Header or Detail).
    • If the processing level is Header, the payment is made at the claim level once all claim lines (Detail) have been completed and approved.
    • If the processing level is Detail, payment is made at the claim line level as it is completed and approved.
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