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Encounter Rate Library with Claim Detail Rules Report

The Encounter Rate Library with Claim Detail Rules report includes information from the Encounter Rate Billing library in File Maintenance. Information on the report pulls from the Encounter Rate Billing Library Maintenance window > Claims tab. The report includes the following information:

ColumnDescriptionData Populates From
DescriptionLibrary NameEncounter Rate Billing Library field
ER Claim Detail RuleER Claim Detail Rules DescriptionEncounter Rate Claim Detail Rules window > Description field
Eff DtEffective DateEncounter Rate Claim Detail Rules window > Effective Date field
Exp DtExpiration DateEncounter Rate Claim Detail Rules window > Expiration Date field
Prim Include Copay IndInclude Copay in Primary Electronic ClaimEncounter Rate Claim Detail Rules window > Primary Electronic Claims section (Y/N)
Prim ER SIM on the ClaimDo you send the ER SIM on the Claim?Encounter Rate Claim Detail Rules window > Primary Electronic Claims section (Y/N)
Prim Display narr on ER SIMPrimary Display narrative on ER SIM charge lineEncounter Rate Claim Detail Rules window > Primary Electronic Claims section (Y/N)
Prim Pull Narrative Data FromPrimary pull narrative data from fieldEncounter Rate Claim Detail Rules window > Primary Electronic Claims section
Prim ER SIM AmtWhat is the ER SIM Amount?Encounter Rate Claim Detail Rules window > Primary Electronic Claims section
Prim ER SIM PositionIs the ER SIM the first or the last line item on the claim?Encounter Rate Claim Detail Rules window > Primary Electronic Claims section
Prim ER SIM ElementWhat data element is the ER SIM on the claim?Encounter Rate Claim Detail Rules window > Primary Electronic Claims section
Prim Value CodeWhat value code is sent on the claim?Encounter Rate Claim Detail Rules window > Primary Electronic Claims section
Prim Orig Chg on ClaimDo you send the original charge lines on the claim?Encounter Rate Claim Detail Rules window > Primary Electronic Claims section (Y/N)
Prim Orig Chg AmtDo the original charge lines have a dollar amount or are they sent as $0?Encounter Rate Claim Detail Rules window > Primary Electronic Claims section
Sec Include Copay IndInclude Copay in Secondary Electronic ClaimEncounter Rate Claim Detail Rules window > Secondary Electronic Claims section (Y/N)
Sec ER SIM on the ClaimDo you send the ER SIM on the Claim?Encounter Rate Claim Detail Rules window > Secondary Electronic Claims section (Y/N)
Sec Display narr on ER SIMSecondary Display narrative on ER SIM charge lineEncounter Rate Claim Detail Rules window > Secondary Electronic Claims section (Y/N)
Sec Pull Narrative Data FromSecondary pull narrative data from fieldEncounter Rate Claim Detail Rules window > Secondary Electronic Claims section
Sec ER SIM AmtWhat is the ER SIM Amount?Encounter Rate Claim Detail Rules window > Secondary Electronic Claims section
Sec ER SIM PositionIs the ER SIM the first or the last line item on the claim?Encounter Rate Claim Detail Rules window > Secondary Electronic Claims section
Sec ER SIM ElementWhat data element is the ER SIM on the claim?Encounter Rate Claim Detail Rules window > Secondary Electronic Claims section
Sec Value CodeWhat value code is sent on the claim?Encounter Rate Claim Detail Rules window > Secondary Electronic Claims section
Sec Orig Chg on ClaimDo you send the original charge lines on the claim?Encounter Rate Claim Detail Rules window > Secondary Electronic Claims section (Y/N)
Sec Orig Chg AmtDo the original charge lines have a dollar amount or are they sent as $0?Encounter Rate Claim Detail Rules window > Secondary Electronic Claims section
Sec CAS Reason CdSecondary Payer CAS Reason CodeEncounter Rate Claim Detail Rules window > Secondary Electronic Claims section
Ter Include Copay IndInclude Copay in Tertiary Electronic ClaimEncounter Rate Claim Detail Rules window > Tertiary Electronic Claims section (Y/N)
Ter ER SIM on the ClaimDo you send the ER SIM on the Claim?Encounter Rate Claim Detail Rules window > Tertiary Electronic Claims section (Y/N)
Ter Display narr on ER SIMTertiary Display narrative on ER SIM charge lineEncounter Rate Claim Detail Rules window > Tertiary Electronic Claims section (Y/N)
Ter Pull Narrative Data FromTertiary pull narrative data from fieldEncounter Rate Claim Detail Rules window > Tertiary Electronic Claims section
Ter ER SIM AmtWhat is the ER SIM Amount?Encounter Rate Claim Detail Rules window > Tertiary Electronic Claims section
Ter ER SIM PositionIs the ER SIM the first or the last line item on the claim?Encounter Rate Claim Detail Rules window > Tertiary Electronic Claims section
Ter ER SIM ElementWhat data element is the ER SIM on the claim?Encounter Rate Claim Detail Rules window > Tertiary Electronic Claims section
Ter Value CodeWhat value code is sent on the claim?Encounter Rate Claim Detail Rules window > Tertiary Electronic Claims section
Ter Orig Chg on ClaimDo you send the original charge lines on the claim?lEncounter Rate Claim Detail Rules window > Tertiary Electronic Claims section (Y/N)
Ter Orig Chg AmtDo the original charge lines have a dollar amount or are they sent as $0?Encounter Rate Claim Detail Rules window > Tertiary Electronic Claims section
Ter CAS Reason CdTertiary Payer CAS Reason CodeEncounter Rate Claim Detail Rules window > Tertiary Electronic Claims section
Crt DtCreate DateModification Information
Created ByCreated ByModification Information
Mod DtLast Modified DateModification Information
Modified ByLast Modified ByModification Information

Filter 2

Use columns to filter data on the report. Column filter options include the following:

  • Between
  • Equals
  • Not Equals
  • Greater Than
  • Less Than
  • Like

Sorting

Use columns to sort and group data on the report. Column sorting options include the following:

  • Ascending
  • Descending
  • Group By
  • Page Break

Totals

Use columns to sub-total and total data on the report. Column total options include the following:

  • Sum
  • Average
  • Count
  • Totals