Edit Claim Information

1.1

View the desired specialty case details.

1.2

Click Edit to display the Speciality Claim Case window.

1.3

Edit case information as follows

Specify Specify Case information as follows

Policyholder

Click the Policyholder button and specify the policyholder using the Policyholder Search window.

Claimant

Click the Claimant button and specify the claimant from the Account Claimant Search window. Note that the Claimant button only becomes active after you've picked a policy.

Case

Check the box corresponding to the case type.

Referral Source

Choose who referred the case from the drop-down list.

Received Date

When the case referral was received. Enter the date directly in the field in MM/DD/YYYY format or click the calendar icon and set the date using the date picker tool.

Primary ICD-10

Click the button and specify the primary ICD-10 diagnosis using the Select Claim Diagnosis window .

Status

Specify case status using the drop-down list.

Status Last Updated

When case status was last updated. Enter the date directly in the field in MM/DD/YYYY format or click the calendar icon and set the date using the date picker tool.

Assigned To

Click the button and specify who the case is assigned to using the Assigned To window.

Date Assigned

When the case was assigned. Enter the date directly in the field in MM/DD/YYYY format or click the calendar icon and set the date using the date picker tool.

Case Disposition

Specify case disposition using the drop-down list.

Case Closed Date

When the case was closed. Enter the date directly in the field in MM/DD/YYYY format or click the calendar icon and set the date using the date picker tool.

Specify Transplant information as follows

Transplant

Select the transplant from the drop-down list.

Pre-Evaluation Notice

Check Yes if there was a notice prior to evaluation.

Patient Evaluation Date

When the patient was evaluated. Enter the date directly in the field in MM/DD/YYYY format or click the calendar icon and set the date using the date picker tool.

Transplant Date

When the transplant was performed. Enter the date directly in the field in MM/DD/YYYY format or click the calendar icon and set the date using the date picker tool.

Specify Neonate information as follows

Gestation

Enter gestation weeks and days in the corresponding fields.

Date of Birth

Enter date of birth for the child. Enter the date directly in the field in MM/DD/YYYY format or click the calendar icon and set the date using the date picker tool.

Review

Check the box corresponding to the case review method.

Discharge Date

When the hospital discharge occurred. Enter the date directly in the field in MM/DD/YYYY format or click the calendar icon and set the date using the date picker tool.

Specify Healthcare Facility / Network information as follows

Healthcare Facility

Click the button and specify the healthcare facility using the Company Search window.

PPO Network

Click the button and specify the PPO Network using the Company Search window.

Specify Vendor information as follows:

Vendor is the PPO Network

Check Yes if the vendor is also the PPO Network. Otherwise check No and click the Vendor button to specify the vendor using the Company Search window.

Date Sent to Vendor

When the case was sent to the vendor. Enter the date directly in the field in MM/DD/YYYY format or click the calendar icon and set the date using the date picker tool.

Date Contract Placed/Accepted

When the contract was placed or accepted. Enter the date directly in the field in MM/DD/YYYY format or click the calendar icon and set the date using the date picker tool.

1.4

Click Save.