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Components of the Patient Insurance - Encounter window

Components of the Patient Insurance - Encounter window

Field	Description
Assignment of Benefits	Select one of the following options: No Patient Refuses to assign Yes
Release of Information	Select one of the following options to identify the release of information status: Approp Rel on File at Svc Prov Inf Consent to Rel Med Info Limited Ability to Rel Data No, Provider Not Allowed On File at Payer or Plan Sponsor Yes, Signed Stmt Perm Rel
Notified by	Enter the name of the person who sent the notification.
Notification date	Enter or select the date of notification.
Verified by	Enter the name of the person who verified the insurance.
Verification date	Enter or select the date the insurance was verified.
Claim Level Authorizations	Do one of the following: In the Claim Level Authorization list (displays only active authorizations): Select the applicable claim-level authorization to link to the encounter. Clear the applicable claim-level authorization to remove from the encounter. Select open menu and select one of the following options: Open to access the Authorization Listing window and open, create, or delete a claim level authorization. Show all Authorizations to display a list of all active and inactive authorizations attached to the payer.
Use remaining encounter authorizations	Select this check box to apply an existing claim-level authorization to an encounter.
Claim Level Referrals	Do one of the following: In the Claim Level Referral list (displays only active referrals): Select the claim-level referral that you want to link to the referral. Clear the claim-level referral that you want to remove from the referral. Select open menu and select one of the following options: Open to access the Referral Listing window and open, create, or delete a claim-level referral. Show all Refunds to display a list of all active and inactive authorizations attached to the payer.
Use remaining encounter referrals	Select this check box to apply an existing claim-level referral to an encounter.
Line Level Authorizations	Do one of the following: Select the applicable line-level authorization to attach it to the encounter. Clear the applicable line-level authorization to remove it from the encounter. Select open menu to access the Authorization Code Tracking window and create or modify a line-level authorization.
Line Level Referrals	Do one of the following: Select the applicable line-level referral to attach it to the line-level charge. Clear the applicable line-level authorization to remove it from the line-level charge. Select the open menu button to access the Referral Code Tracking window and create or modify a line-level referral.
PRO Procedure	Select one of the following options: (look up in book) Extraction of lens Extraction of lens - 30 Extraction of lens - 40 Removal of lens material Removal of lens material - 50 Remove cataract - 84, insert lens
PRO State	Enter or select the PRO state.
PRO Date	Enter or select the PRO date.
Certificate of Medical Necessity	Do one of the following: Select the applicable certificate of medical necessity. Select to access the Certificates of Medical Necessity Information window.
Property/Casualty Number	Enter the property or casualty number.
Date Appliance Placed	This field appears only when the primary payer on the encounter is a dental payer. Enter the date the patient had a dental appliance placed. The date prints on paper ADA claims and is included on electronic 837D claims. Note: The Dental payer check box must be enabled in File Maintenance on the Payer Information window Defaults-2 tab.
Date Appliance Removed	This field appears only when the primary payer on the encounter is a dental payer. Enter the date the patient had a dental appliance removed. The date is not included on paper ADA or electronic 837D claims. Note: The Dental payer check box must be enabled in File Maintenance on the Payer Information window Defaults-2 tab.