Add or Remove Claim ID Decimal

This rule will instruct the system when to add or remove the decimal from the Avea Claim ID on the claim form.  

Workflow

Let's review how to create a claim rule to add or remove the decimal from the Avea Claim ID!

• 1. Navigate to Management Center > Claim Rules.
     
     
  2. Click Create Claim Form  Rule.
     
  3. Select the Practice.
     
  4. Next, give the rule a name.
  5. Update the Claim Type to Institutional or Professional.
     
  6. Select Conditions to create criteria a claim should meet before the rule will apply.
     
  7. Next, click on the Behaviors dropdown.
  8. Select Claim ID - Decimal.
     
     
  9. Next, click Add.
     
  10. Update the dropdown to one of the following choices:
      1. Omit to create the claim without the decimal present. 
      2. Write to Claim to only include the decimal
  11. To create multiple behaviors, repeat steps 7-10.
  12. Click Save to complete the process.
       

Box Number(s)

• UB-04: Box 3a - Patient Control Number
• CMS-1500: Box 26 - Patient's Account Number

Helpful Hints

• This rule is used to correct and resolve a rejection for using a non-alphanumeric character in the patient's account number. For more information about the rejection, click here.
• If one of your conditions is payer-based, select Current Sequence Behavioral instead of the Primary Behavioral Payer. This will ensure the rule applies to secondary and tertiary claims when needed. 
• 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.