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Claim Form Rules
Update Bill-Type Prefix
Update Bill-Type Suffix
Use Facility or Practice Address as Billing Provider Address
Use Facility or Practice NPI as Billing Provider NPI
Use Facility Name or Practice Name as Billing Provider Name
Manage Billing Provider Tax ID
Add or Remove Billing Provider Taxonomy Code
Add or Remove Condition Codes
Add or Remove Claim Form Service Names
Add or Remove Claim ID Decimal
Add Diagnosis Related Group (DRG) Code
Manage Diagnosis Present on Admission Flag
Use Custom Facility Name
Add or Remove Other Diagnoses
Add or Remove Service Line Note
Add or Remove Occurrence Codes
Add Claim Form Procedure Description
Add or Remove Patient Reason for Visit Code
Add or Remove the Blue Shield Provider Number
Add or Remove CLIA Number
Add Institutional Secondary Provider ID
Add PCS Codes
Add or Remove Patient Admit Date
Add or Remove Patient Admit Hour
Add or Remove the Patient Admit Type
Add or Remove Patient Admit Diagnosis
Add or Remove Patient Discharge Date
Add or Remove Patient Discharge Hour
Add or Remove Patient Discharge Status
Add or Remove Payer Claim Mailing Address
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<% var getColumnClasses = function(columnNumber) { var classNames = numberColumns === 'auto' ? 'col-auto' : 'col-12'; if (numberColumns >= 2) classNames += ' md:col-6'; if (numberColumns >= 3) classNames += ' lg:col-4'; if (numberColumns >= 4) classNames += ' xl:col-3'; return classNames; } %> <% var getColorClasses = function(color, index) { if (color === 'white') { if (index === 0 || index === 3) return 'bg-secondary text-secondary-inverse'; if (index === 1) return 'bg-tertiary text-tertiary-inverse'; if (index === 2) return 'bg-primary text-primary-inverse'; } return 'bg-' + color + ' text-' + color + '-inverse'; } %>
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<% var getColumnClasses = function(numberColumns) { var classNames = 'col-12'; if (numberColumns >= 2) classNames += ' md:col-6'; if (numberColumns >= 3) classNames += ' lg:col-4'; if (numberColumns >= 4) classNames += ' xl:col-3'; return classNames; } %>
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