Claim Form Rule: Adding Remarks

  • Updated

What claim change is needed?

To add additional details or information on the UB-04 claim to help the payer interpret what action was completed during the patients' encounter.

Box Number

UB-04: Box 80

Steps

  1. Navigate to Management Center > Claim Rules
  2. Click "Create Claim Form Rule".
  3. Select the Practice.
    mceclip2.png
  4. Name the claim rule.
    Screen_Shot_2021-05-23_at_2.24.44_PM.png
  5. Set Claim Type to Institutional.
    mceclip1.png  
  6. Set conditions for the claim rule to be met.
    Typically, this is a payer requirement so you'll select the appropriate payer type (i.e. Primary Behavioral Payer).
  7. Select the Available Behavior: Remarks.
    Screen_Shot_2021-05-23_at_2.24.56_PM.png
  8. Then click Add.
  9. Choose which option fits the behavior: if the payer requires additional remarks, select the option: Require and write to Claim; if the remarks are available, but not a requirement, then write the remarks to the claim.  
    Screen_Shot_2021-05-23_at_2.25.09_PM.png
  10. At the bottom of the window, click the Create button.

Related Articles

To read more about how to set claim rule conditions and order, see the Claim Rule: Setting Claim Rule Conditions article.

To read more about how to set up a claim rule to be effective as of a certain date, see the Scheduled Change Sets article.

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