Overview
The Plan: New and Plan: [name] pages are comprised of twelve tabs:
- General Tab
- Claims Tab
- Statements Tab
- Anesthesia Tab
- Provider IDs Tab
- Referring Physician IDs Tab
- Facility IDs Tab
- Group IDs Tab
- Practices Tab
- Paper Claim Options Tab
- Electronic Claim Options Tab
- Other Insurance Codes Tab
The Electronic Claim Options tab displays a read-only view of the claim options configured for electronic claims. This configuration determines the data sent in a plan's electronic claim clearinghouse file. The claim options are configured with the clearinghouse specifications of the plan provided to Solutions. You cannot change any information displayed on this tab. Solutions maintains the electronic claim options configuration. If a change is required to this configuration, enter a ticket through Solutions Support Center to request the change.
Note: This tab is not accessible from the Plan: New page until the General and Claims tabs have been populated and applied.
Field Definitions
Field | Type | Required | Description |
---|---|---|---|
Field Name | Read-only | Yes | Corresponds to the ANSI loop and segment in the electronic claim file that contains data from the case. The ANSI loops and segments are sorted alphabetically by name. |
Group Billing Columns | Columns specific to the practice type of Group, indicating that the practice group bills by provider group. | ||
Primary Claim | Read-only | Yes | Contain the values of the ANSI loop and segment for primary claims. |
Secondary Claim | Read-only | Yes | Contain the values of the ANSI loop and segment for secondary claims. |
Individual Billing Columns | Columns specific to the practice type of Solo Provider, indicating the practice bills for an individual provider. | ||
Primary Claim | Read-only | Yes | Contain the values of the ANSI loop and segment for primary claims. |
Secondary Claim | Read-only | Yes | Contain the values of the ANSI loop and segment for secondary claims. |