Claim Detail

Use this page to view and/or print specific and detailed information about a claim.

Tip: The information displayed on this page is read-only and cannot be changed.

Viewing Claim Detail Information

The following information is displayed for each claim:

Claim # displays the file identification number of the claim.
Patient Acct. displays the child's providers patient account number.
Auth # displays the authorization number for the claim.
Submitted Date displays the date the claim was recorded.
Total Amount Billed displays the total amount billed for the claim.
Adjustment Reason displays the reason for which the claim was adjusted, if applicable.
Status displays the status of the claim.
Resubmitted Reason displays the reason for which the claim was resubmitted, if applicable.

In the columns of the Claim Line Detail table, view the following information for each line item associated with a claim:

Line displays the line number for the claim line item.
Date (or Service Date) displays the date on which the claim line item was provided.
Place of Service displays the location where services were rendered.
EI Code displays the procedure code for the claim line item.
HCPCS Code displays the HCPCS code for the claim line item.
CPT displays the CPT code for the claim line item.
ICD9 Code displays the ICD9 code for the claim line item.
Units displays the number of units provided for the claim line item.
Billed (or Amount Billed) displays the dollar amount charged for the claim line item.
Disallowed displays the dollar amount disallowed for the claim line item.
Denied displays the dollar amount denied for the claim line item.
Reason displays the reason why the claim line item was denied.
Medicaid Reason provides a link to the medicaid denial reason page. Click the link in this column to display the Medicaid Denial Reason page.
Previously Paid displays the dollar amount previously paid on the claim line item.
Net displays the net amount paid for the claim line item.

Note: Some of the columns listed above may not display, depending on the type of claim viewed and the requirements of your state.

Click the following button(s) as necessary:

Click Print to print the current claim on your printer.
Click Resubmit to resubmit the claim. The Claim Entry (Service tab) page displays.
Click Correct Claim to correct the entries on the claim.
Click Back to return to the previous page.

Note: Some of the buttons listed above may not display, depending on the user's security rights and the status of the claim.

Click the following link(s) to see how to complete a task step-by-step: