Claims Summary Screen





 

Search Parameter Name

Function

Order By You may specify how to order the search results here. Options include DOS Earliest, DOS Earliest DESC (in descending order), Claim Number, Employee Last Name, Provider Tax ID and Employee SSN.
Claim Status You may limit your search to a specific claim status. Options include ALL, DATA, DONE, DOEO, DOPR, PEND, PROC and PMCI.
Group ID You may search for claims by specifying the Group ID here.
DE/Proc Operator You may search for claims by specifying the operator who processed the claim here.
DOS Text Entry Field (5) You may search for claims by Earliest Date of Service. The date should by specified in DD/MM/YY format.
Claim Number Text Entry Field (6) You may search for claims by specifying the claim number here.
Employee Last Name Text Entry Field (7) You may search for claims by specifying the Employee Last Name here.
SSN Text Entry Field (8) You may search for claims by specifying an Employee's SSN here.
Patient/SSN Suffix Text Entry Field (9) You may specify the Suffix (01- Employee, 02- Spouse, 03- First dependent child, 04- Second dependent child etc) of a specific patient in the claims search.
Provider ID You may search for claims by provider ID.


 

Button Name

Function

Clear Search This will clear all search results from the screen. Clicking here will also clear all search parameters except the "Order By" parameter.
Search Clicking here will take any specified parameters and search for all claims which match those parameters. No parameters are required but the search will not find any claims until at least one parameter is stated.


  The Claims Detail tab closes the Claims Summary screen and opens the Claims Detail screen. 


 

Button Name

Function

EVT This is a speed button to the Event Tracking screen, which will open to all events correlated with the currently selected claim.
ELG This is a speed button to the Enrollment screen, automatically opening to the employee whose claim is currently selected in this screen.
Copy PROV
This will generate a copy of the original Provider statement in report form (for viewing or printing), for the currently selected claim. The difference between the original and the copy, is that the copy doesn't have a real signature, and says COPY.
Copy EOB
This will generate a copy of the original Employee Explanation of Benefits statement in report form (for viewing or printing), for the currently selected claim. The difference between the original and the copy, is that the original says VOID and this one says COPY.
RPT This opens the Eligibility Reports window.
LTR This opens the Letters window.
ADM This opens the Administration Tools window.
ELG This opens the Enrollment screen.
CLM This shows that the Claims Entry screen is open.
NWK This opens the Networks and Providers screen.
EVT This opens the Event Tracking screen.
PLN This opens the Plans and Options screen.
GRP This opens the Groups, Locations, and Units screen.


  This button closes the Claims Manager program.