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Claim Form Rules

  • Add or Remove Accident Type
  • Add or Remove DOH License Number
  • Add or Remove Facility - Secondary Tax ID
  • Add or Remove Facility - Location Number
  • Add or Remove MRN
  • 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
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