Save time and effort by quickly creating multiple claims from a single encounter. This greatly reduces the manual effort required to create claims with the same or similar information. The created claims will automatically go through the claim scrubbing process, and you can quickly make corrections if needed.
For example, assume you want to send a claim with a lab location and another with an office location. The claim-splitting feature lets you do that with just a click of a button.
Encounter and Split claims
Access an encounter (new or imported)
The Split Claims button will appear only when:
- There is more than one line item in the encounter
- At least one line item has a location different from the encounter location
- The encounter doesn't have a previous claim or a payment (applied or unapplied)
Click Split Claims
A pop-up appears in which line items are grouped based on the location. For example, if the first line item has a location, it will be grouped under the associated location. If a line item doesn't have a location, it will be grouped under the encounter level location.
Drag and drop line items to change the grouping.
Remember, the number of non-empty groups will be equal to the number of claims or encounters created and the line items in a group will appear in the claims/encounters created.
Create encounters or claims
Click Save Encounters to create encounters associated with the groups. The encounters will be present in the Unbilled tab.
Click Save Claims to create and save claims associated with the groups. The claims are saved in the Ready to Send tab after successful claim scrubbing.
Click Send Claims to create and send claims associated with the groups. The claims are sent to the payer after successful claim scrubbing.
Every encounter created through splitting has a note indicating the parent encounter.
The parent encounter also has a note listing all the encounters that were created from the parent encounter.
Split claim defaults
To set defaults, navigate to Utilities > Practice Setup > Procedure Codes.
Select a procedure code or create a new procedure code.
Click the Split Claim Defaults button.
A pop-up opens with the Place of Service, Rendering Provider, and Billing Provider fields.
Select values in one or more fields.
If split claims defaults are setup for at-least one CPT code used in an encounter then the split claims defaults configured about will be used for claim/encounter splitting rather than just using the place of service as the splitting criteria. These defaults will be applied at the claim/encounter level for every claim/encounter in that group.
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