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Revision History
| Version | Date | Description |
|---|---|---|
| 1 | 01/29/2024 | Added information on Box 15 auto-population feature and the configurations required. |
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Getting Started
Healthcare providers must adhere to the guidelines outlined by the CMS when submitting the HCFA claim form. Box 15 on the HCFA claim form necessitates users to fill in the Visit Qualifier and Onset/Hospitalization Date information.
As a measure to save time and make claim submission easier, the application now allows you to enter the Visit Qualifier and Visit Qualifier Date in the patient demographics. The application automatically populates this Visit Qualifier and Visit Qualifier Date information in Box 15 of the claim form. The new enhancement helps save time, make claim submission easier, and reduce claim errors.
Prerequisites
1. The administrator must enable the Box 15 auto-population feature in the Globals window.
2. The visit qualifier details must be added in the patient demographics.
Enable box 15 auto-population in HCFA claim form
As a prerequisite, the administrator must select the visit categories and insurance providers applicable for Box 15 auto-population. The application auto-populates the patient’s visit qualifier details only for the claims associated with the selected visit category and insurance provider. The administrator can configure this from the Billing section of the Globals window.
To select the visit categories applicable for box 15 auto-population
3. Sign in to the application.
4. Click the user settings icon The user settings menu appears.
5. Click Globals.
The application displays the Globals window.
6 On the left pane, click Billing.
The application displays the billing configurations
7. From the Visit Category field under Enable Box 15 Auto Population, select the required visit categories applicable for box 15 auto-population.
Note: You can use Ctrl + click to select multiple visit categories.
8 Click SAVE. The application saves the changes.
To select the insurance providers applicable for box 15 autopopulation
1. In the Globals window, click Billing. The application displays the billing configurations.
2. In the Insurance field under Enable Box 15 Auto Population, select the insurance providers applicable for Box 15 auto-population.
Note: You can use Ctrl + click to select multiple insurance providers.
3. Click SAVE. The application saves the changes.
Add visit qualifier and date for a patient
The application provides you with the option to add the visit qualifier details for each patient. You can add the visit qualifier and date in the Misc section of the patient demographics.
Note: The auto-population of Box 15 will occur only for encounters created after implementing the above configurations. The previous encounters will remain unaffected.
To add the visit qualifier details for a patient
1. In the Search Patients field, enter the patient name or PID. The application displays the list of patients that match the search keyword. BOX 15 AUTO-POPULATION IN HCFA FORM 7
2. Select the required patient. The application displays the patient facesheet window
3. Click the edit patient icon.
The Current Patient window appears.
4. From the Visit Qualifier dropdown list, select the visit qualifier applicable for the patient.
5. In the Visit Qualifier Date field, select the visit qualifier date.
6. Click SAVE.
The application saves the changes and displays the patient facesheet window.
Visit qualifier and date auto-population in HCFA claim form
When you add the visit qualifier and date in the patient demographics, the application automatically populates the visit qualifier and date in the Box 15 field of the feesheet. You can find the Box 15 fields in the MISC section of the feesheet.
