Direct Data Entry
  • 19 Apr 2024
  • 4 Minutes to read
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Direct Data Entry

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Article Summary


This article will cover how to directly enter data into a blank form within the Claim.MD system, which is designed to resemble a traditional paper form for user-friendliness. It will cover two methods of direct data entry: 

  • Entering a new patient using this blank form, 
  • Updating and sending claims for existing patients already entered into Claim.MD.

To enter a blank claim for a new patient:

  1. Click on Manage Claims on the left-hand navigation menu
  2. Click  button on the top of the page.
  3.  A New Blank Claim pop-up box will display.
  4. Enter patient and/ or provider information if this is known.
  5. Click   button.
  6. A blank View/Edit Claim screen will display. From here, all red fields must be filled out.
  7. Once this is completed and the information is reviewed for accuracy, click on the top right.

IMPORTANT!
The  PATIENT ACCT # (Box 26), needs to be a unique identifier for each patient. This ID number is assigned by the user in Claim.MD and returned by the payer in all their correspondences. Examples might be (1234)  or SJONES26. 

To enter a blank claim for an existing patient:

  1. Click on Manage Claims on the left-hand navigation menu
  2. Click  button on the top of the page.
  3. A New Blank Claim pop-up box will display.
  4. Enter account# or patient last name into the Patient field for any patient already in the system (Patient ID#, Last Name/First Name).
    You can also enter Billing and Rendering Provider Name or NPI to populate this data into the claim. 
  5. Click  button.
  6. The View/Edit Claim page will display with the patient information already populated. For example, In the image below, Prissy Smith's info is now populated in the fields. 
  7. Review and change this information as needed. 
  8. Click   at the top of the page when finished entering data.

Adding Diagnosis Code and Date of Service

  1. In Box 21, review/edit the diagnosis code(s). If more than one code needs to be entered, do that here. 
  2. In Box 24, add the Date of Service (type in the date ##/##/### or use the calendar feature).  Also add the Procedure code, Diagnosis Reference, and Units.  
  3. Click  button on top of page when finished.
More Information
Adding Additional Charges
If a second service line is needed, click the button and it will add a second line.

Deleting Additional Charges

To delete a service line efficiently, start by deleting the From Date for the line to be removed. With the cursor in that field, press the TAB key to navigate to the next field in the line, then use the DEL key to delete that information. Repeat this process until you reach the end of the line. All the fields in that line should now be blank. Upon saving, the entire line will be removed.

Additional Narrative

The Additional Narrative field is commonly employed for unspecified codes in procedures and National Drug Code (NDC) classifications, enabling users to directly input text. This facilitates the inclusion of additional details for drug names and measurements when specific codes are unavailable, ensuring accurate documentation for insurance claims. For instance, users can describe a surgical tray containing five cotton swabs and two needles without explicitly provided codes, enhancing comprehensive record-keeping for procedures and drug-related items.

Attachments

Allowing Attachment
Please note, not all payers or their claim submission trading partners allow attachments.

Here is a link to those payers which currently allow attachments:

Payers Which Currently Allow Attachments

Once a claim is created or uploaded to one of the payers in the list above, there will be an Attach Documents link at the top of the claim's form in Claim.MD. 

  1. Click on the Attach Documents link. 
  2. Click on Select A File.
  3. Select the file from your local drive.
  4. Close the Attach Document Window.
  5. The link will now display the number of documents attached.
  6. Be sure to select the appropriate Attachment Type.

Sending Claims by Fax or Mail

Submitting a claim through fax or mail follows a straightforward process. It's important to be aware that when opting for mail submission, the organization has two choices: 

  • produce a printout of the claim in-house, or 
  • opt for the convenience of utilizing Claim.MD's service to print and dispatch the claim on behalf of the biller/provider.
More Information
  • The fax cover sheet is not customizable. 
  • Before sending the claim by fax or mail, users can open and review a printed HCFA 1500 version in Claim.MD by clicking on the "Printer" icon situated at the top right corner of the screen.

To have Claim.MD send a claim via fax:

  1. If the payer accepts faxed claims, obtain their fax number and modify the Payer ID field to FAX01 to send the claim.
  2. Add the payer's fax number in the Address 2 field. 

To have Claim.MD send a claim via mail:

  1. If the payer accepts paper claims, enter the word PAPER as the Payer ID
  2. Since the claim has been manually entered, the payer address needs to be entered. Please note, Claim.MD does not maintain a list of payer addresses.

To print out a claim to be faxed or mailed in-house:

  1. Click on the Printer icon  to the very top right of the screen.
  2. From the Claim Form dropdown, make sure Print Claim With Form is selected. 
  3. On the Print Claim window, click button.
  4. A PDF window will generate with the paper version of the form. From here, the document can be printed to be mailed or faxed in-house.

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