Rules for Payers
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Jeremy Ponds
As noted in Caroline's comment below - having the ability to both create rules by payers like she indicated AND I would actually like to see this set up as something that can be toggled in the claim settings/options under EACH PATIENT --> in other words, where you can currently set "Claim defaults" - add fields where you can set a specific diagnosis, POS, modifier, Provider combo that defaults so that repetitive visits don't have to be screened each time to make sure the claim is fully correct before sending it out.
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Jeremy Ponds
Yes please - this would be very helpful! There are specific instances where it varies both by insurance and by state!
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Christopher Callahan
I completely agree with this one. We had an incredible hassle this past year with Cigna speech. Aetna credentials that same way, but fortunately hasn't been a problem.
Caroline Brown Bias
I agree and would love to be able to create "rules" related to claims in general. Examples "when x is true, use modifier ___" "when y is true, use POS ____" "when provider is ____ and insurance is ____", "when time is ____ bill x units" etc. I can give more examples if helpful. I currently set up several versions of my payers with weird workarounds to achieve some of this but that also causes a bit of confusion in other ways.