QuickEMR has a settings called Combined Claim that is specific to each insurance. Some insurance companies allow multiple dates of service to be combined onto one claim. Taking advantage of this can reduce workload for billing personnel and reduce cost per claim fees charged by insurances and clearing houses.
How do I enable Combined Claim?
1. Combined claim may be enabled on the insurance setting screen by setting the "Combined Claim" checkbox. Make sure to save after changing any settings on this screen.
2. Optionally if you want to set this for all insurances you may visit "Settings" => "Billing" and select the "Combined Claim" button. This will enable the combined claim setting for all insurances that are marked as EDI (electronic billing). EDI is the default setting for an insurance so you may need to manually edit your paper claim insurances to update the claim type before using this bulk update. Warning, this button does not have a "reverse". Undoing the setting will require manually visiting every insurance record and clearing the checkbox.
Under what conditions will a combined claim setting combine claims?
1. Claims will only combine if
a. The case has a primary insurance record.
b. The primary insurance has the "Combined Claim" checkbox set.
2. EZClaim must have a claim that is open for the given case:
a. "Ready to Submit" status
b. Assigned to the primary payer.
c. Does not have a "Resubmit Code"
3. In addition the following values must match between the given note in QuickEMR and a claim in EZClaim.
a. Patient. The case must have been exported to EZClaim and will only combine with the mapped account in EZClaim.
b. Billing Provider. This will be the co-signer if one is present.
d. The Year of the DOS. 2018 and 2019 claims will never combine.
e. Diagnosis and the order of the diagnosis. Adding a new diagnosis or swapping the order of the first and second diagnosis will prevent the claims from combining as the diagnosis pointers would no longer be accurate in the Claim.
f. Insurance, insurance policy number, insurance order. If a new insurance is added or the primary/secondary insurances are swapped the note will not combine with an open claim.
g. Authorization #. As authorizations can not actually be assigned to notes in QuickEMR at this time the check simply insures both notes occurred during the same authorization period.
h. Place of Service.
4. If the primary insurance is institutional (usually medicare) additional fields must match:
a. Type of Bill. This effectively insures that Evaluation, Visit Notes, and Discharges are not combined. A re-evaluation or progress note may be combined with a previous visit note.
b. Patient Status. This is only differentiated for discharge notes.