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Claim Form Rules

  • 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
  • Add or Remove the Payer Assigned Provider ID
  • Add or Remove Facility Payer-Assigned Provider ID
  • Update the Service End Date
  • Treat Episode as Discharged
  • Add or Remove Value Codes
  • Add or Remove the Pay-To Address
  • Update Resubmission Code
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