Provider Quick Guide
Contents
1. Enter Patient share Select Out of Net or Gross Enter Maximum Patient share Check the Is Active check box Click on Save button a Se S If price lists are uploaded with the concerned activities it will override the equation set here eClaimLink A ProviderLink application Claim Form Authorization Form Patients Encounters Authorizations Claims ae Tracking Settings Insurance Plans Prices List Backup Data enayaA Category C the description for D Testing plan B test Insurance Plan Description Discount Rate 36 Patient Share 6 Name Category A Category C Category D Category B Category VIP Insurance Plan Information Out Of lt lt Select gt Max Patent Share Is Acti ve INS001 INS001 INS001 INS001 INS001 ReceiverLicense INS001 INS001 INS001 INS001 INS001 25 12 Settings Page Price Lists The Settings module allow you to Search for existing Prices Add New Prices Edit and Delete Prices Also Import and Export Prices Sheet To Add new Prices navigate to the Add Price button then you need to 1 E 2 o Select Activity The Activity is a auto fill field Enter the first 2 or 3 letters of the plan payer name or code and the2. eClaimLink www eclaimlink ae eClaimLink A applications ProviderLink Healthcare Providers eClaim Application User Guide Release 1 0 MAY 2012 oy aall 44 r DUBAI HEALTH AUTHORITY in partnership with Dimensions HEALTHCARE ProviderLink a Table of Contents Getting Started mini 3 Registration iil Logging In amp Setup 5 ProviderLink SYStEM k D CaM j OA 7 Authorization FO L2 ea 4 St 916 ne EEEE 17 POCOUNMGC IE ACE 5 ccnas asakaratnaninaesnasiasntataiataiasacietaiaistad 19 Authorizations Page k 21 Claims Page 22 AEI ER ss IO eClaimLink Submission Tracking AENEA NE duces NANE EAE AAEN SEEE AEA EEEE AEEA 2 4 eClaimLink is the eClaim project of the Dubai Health Authority implemented in partnership with Settings 25 Dimensions Healthcare with the objectives of establishing a unified standard healthcare language OS E A anan a a e E nE a AE r E a SUPPOMT cmmmitiiiiij iiiliiuiiiiiiinme 29 providing a centralized health data tracking system facilitating eClaim financial and clinical information between payers providers patients amp authorities Empowering the Dubai Health Authority with the needed information to organize strategize and optimize the healthcare setting in Dubai The eClaimLink portal is intended to manage eClaims and health data In addition it will serve to connect all the healthcare community of Dubai and through its many anticipated modules will rais
3. The last 2 sections shall appear when the first 2 section are filled and saved There are 2 types of authorizations Eligibility and Authorization Claim Form Authorization Form Encounters Authorizations Patient amp Encounter Encounter Type Code Eligibility Patient Name Patient ID file number Contact number Member ID Card number Plan Payer Claims No Bed No emergency room DHA FL 0034467 201205111812 ProviderLink Eligibility checks whether the patient is an eligible member with the payer without sending the encounter info just validating on his member ID Authorization type is that requesting approval for specific encounter with detailing its Diagnosis and Activities By entering few letters or numbers of any of the fields of Name Member ID Contact Number or Patient ID the system Shall search to check if you entered this patient earlier on the system and shall fill the form automatically for Patient amp Encounter Information section You cannot edit previous patients info from this form you need to go to Patients section and edit it there ProviderLink Submission Tracking Settings Date Ordered DD MM YYYY 11 05 2012 Emirates ID Emirates ID not available select reason v Clear fields to insert new Patient a eClaimLink A application 12 ProviderLink gt 6 Authorization Form a e Member ID Card Number Member insurance ID as showing on ar Insura
4. 4 5 6 7 9 o a i 2 amp CO FC OC CO Also you can click View to see response from payers on your submission after importing the file and do resubmission for claims as needed gt N ile Search result Back to Remittance List Insurer ID Claims 6e2adfdf 57cb 40ce bb67 f4824c52f324 5 2012 13 46 checkremittance xml cus taro tht o0osan12 1521 8 12 a a E 11 Submission Tracking Page To view submissions navigate to the Submission Tracking Tab In this screen you will be able to track all submissions and if payers responded to with payment details Use the search engine to enter the criteria in which you want to filter your results If you desire to view all submissions leave all fields empty and click on Search button 02 05 2012 02 26 06 03 05 2012 16 38 34 03 05 2012 16 41 14 57 03 05 2012 To Encounter Code Remittance Contains Rejections 02 05 2012 03 05 2012 16 39 54 03 05 2012 16 42 47 ProviderLink eClaimLink application 24 12 Settings Page insurance Plans The Settings module allow you to Add New Plans Edit and Delete Plans To Add new plans navigate to the Add Plan button then you need to 1 Select Insurance Plan The Insurance Plan is an auto fill field Enter the first 2 or 3 letters of the plan payer name or code and the system will show the matching records Enter Description Enter Discount Rate
5. 46 a Emirates ID not available select reason Encounter Header Information Encounter Id Clinician Start Time 11 05 2012 09 22 46 Start Type No Bed No emergency room v Elective Save to enter diagnoses sctivities mi 5 Claim Form Genera The Claim Form screen contains a user friendly form designed to minimize the user s effort in submitting a claim Below is a brief descriptions of the fields found in this form Many fields are populated automatically with suggestions There are 4 sections in this form Patient Information Encounter Header Information Diagnosis Information and Activities Information The last 2 sections shall appear when the first 2 sections are filled and saved AuUTN OFiZatio i Parents COU rs ProviderLink By entering few letters or numbers of any of the fields of Name Member ID Contact Number or Patient ID the system shall search to check if you entered this patient earlier in the system and shall fill the form automatically for Patient Information section You cannot edit previous patients info from this form you need to go to Patients section and edit it there Sud ssic acking Stings sido ide n application Emirates ID eClaimLink A applications re Patient ID file number Contact number 46 Member ID Card number Plan Payer Emirates ID not available select reason Clear fields to insert new Patient oT y Clini
6. Choose File button if ready LL O Se Click on Upload Prices button once Cancel OE Finish To Export Prices sheets Click on Export Prices sheets button 27 12 Settings Page Backup Data The Settings module incorporates a backup option which will allow you to back up your data on the system To backup your data navigate to the backup section specify the name for the back up folder and click Backup button You will then be able to save your backup file locally on your computer device What to backup Backup Encounters Patents Plans Prices ProviderLink Backup 28 13 Support The eClaimLink System is a user friendly platform built around the true needs of payers providers and regulators in the United Arab Emirates If you have any questions regarding the use of the system you can Download ProviderLink Quick Guide Post Support Tickets through the Ticketing System starting June 1 2013 ProviderLink If you still have inquiries you can call us at Dimensions Healthcare Contact Call Center Failure to access system login issues functionality related inquiries etc 600 522 004 support eclaimlink ae 29
7. Page 1 1 3 Submitted Activites Count Diagnoses Count Control Delete 2 2 No Bed No emergency room 25 04 2012 15 53 20 25 04 2012 16 23 20 0 2 Edit 3 3 No Bed No emergency room 25 04 2012 17 29 57 25 04 2012 17 59 57 0 0 Edit Tg 35 35 No Bed No emergency room 01 05 2012 16 23 37 01 05 2012 16 53 37 0 1 Edit Previous Next GoTo Generate Page A dani y vey is ey ao eCi ai m Lin kK Home Info Hub DHD Applications DHPO Claim Form Authorization Form Patients Encounters Authorizations Claims Submission Tracking Settings Proy Encounter Header Information Saved Successfully Encounters should have atleast 1 diagnosis and 1 activity to be claimed else it wil not be included in the claim submission Insurance Plan Dubai Government Program 1 Enaya v Receiver Receiver is the selected insurer Click here to select a different receiver TPA001 Neuron LLC Submission Code June 2012 Enaya Disposition Flag PRODUCTION Save 20 9 Authorizations Page To view previously generated and submitted Prior Requests and Prior Authorization navigate to the Authorizations Page ProviderLink gt Use the search engine to enter the criteria in which you want to filter your results If you want to view all Prior Requests Prior Authorizations leave all fields empty and click on Filter Search button You may also view the results received for the Requests Authorization Yes or No To re
8. system will show the matching records Select Plan Enter Gross Enter Net Select Patient Share Enter Non Standard code if available Click on Save Price button Claim Form Authorization Form Patients Encounters Authorizations Prices Filter Search Activity Type lt lt Select gt gt Activity Code 00103 00104 00214 01230 42800 Import Prices Sheet eClaimLink A ProviderLink ication Submission Tracking NSC Activity Type PlanCode Plan Description CPT P0001 P0002 P0004 enayaA Testing plan B the description for D Category C enayaA ProviderLink Soriication Filter Search acitivities plans prices e NSC 11 011212 200 00 15 00 1234567 2700 00 Activity Plan Price Information Activity Plan lt lt Select gt gt Gross Net Patient Share Non Standard Code temp ProviderLink gt 12 Settings Page Price Lists Import Prices Sheet You must use specific file template with the following columns PlanCode DHA unique code of the plan ActivityCode Code of the activity To Import Prices sheets navigate to the Pan Tet The Ee Ber ROR Gross Import Prices sheets button then you Net nee fi PatientShare need to use specific file template Provider_NSC the non standard code if usedioptional temp Click on Get Sample File to see sample Get Sample File Prices Sheet or click on
9. P Search Select Current Page Clear Selection Claim Selected Claim All Search Result HGaaeaegsabaagbadaGad No Bed No emergency room 25 04 2012 15 53 20 25 04 2012 16 23 20 No No Bed No emergency room 25 04 2012 17 29 57 25 04 2012 17 59 57 No No Bed No emergency room 25 04 2012 17 34 10 25 04 2012 18 04 10 No No Bed No emergency room 25 04 2012 17 37 15 25 04 2012 18 07 15 No No Bed No emergency room 26 04 2012 09 39 45 26 04 2012 10 09 45 No No Bed No emergency room 26 04 2012 09 44 32 26 04 2012 10 14 32 No No Bed No emergency room 26 04 2012 10 09 14 26 04 2012 10 39 14 No No Bed No emergency room 26 04 2012 10 20 47 26 04 2012 10 50 47 No No Bed No emergency room 26 04 2012 10 23 30 26 04 2012 10 53 30 No ProviderLink if if eClaimLink A applications 19 8 Encounters Page Generate Claims To send Claims to dhpo post office you need to 1 Select the related encounters see previous page Click on Claim Selected button Click on Go to Generate Page button If the TPA is receiving the file enter the received ID as indicated e g Enaya is the payer and Neuron is the TPA 5 Enter the submission code ID Click on Save Note Only encounters with at least one activity and one diagnosis can be added in claim submissions Now you can go to Claims Page and see the generated file ProviderLink gt Submission Cart
10. Type Encounter Type choose from the list showing on Insurance Card e Start Type Encounter start type choose from the list e Plan Payer Insurance Company and Plan of the Member this is not the TPA but the payer When entering inpatients more fields End Type and Time shall be requested also more info is requested in patient transfer cases After finish entering the Patient and Encounter Information click the button of Save to enter diagnosis and activities A new sections open for Diagnosis and Activities to enter the remaining information Patient ID file number Emirates ID 46 Emirates ID not available select reason mber ID Card number Pian Payer Clear fields to insert new Patient ProviderLink gt 5 Claim Form Diagnosis Info Here are the definitions of the fields notice some are mandatory denoted x by Diagnoses 2 Click to show diagnoses Diagnosis Inserted Successfully Code Description Edit Diagnosis Delete Diagnosis A01 00 Typhoid fever unspecified Edit Diagnosis Delete Diagnosis A02 24 Salmonella osteomyelitis Secondary az Activities 0 Click to show activities Diagnosis fields e Type Primary Admitting or Secondary Only one Primary Diagnosis or Admitting is allowed but can add several Secondary diagnosis e Code with Description Enter the ICD10 CM code if you know it or enter key word of the diagnosis description you are seeking an
11. Types vary depending on the observation type and nature of needed data Payers may request specific data to be captured and sent in a special DHA approved format Enaya program mandate providers to capture the Presenting Complaint in observation if the Activity Type is a Service and the Code is a consultation code 9 9 1 10 10 1 11 11 1 21 22 23 AS soon as the code is entered the system opens the Presenting Complaint Observation box Also similar case happens when Dental code is entered the system opens the Tooth Number Observation Box to enter tooth if it is applicable With rest of Activity code an optional Description Observation Box appears but not mandatory v 9 Consultation GP DHA PL 0008920 VENKATA PHANI RAJ CH ProviderLink gt Value Type Value Type 0 00 0 00 Presenting Complaint Code Description v D7511 incision and drainage of abscess intraoralgse DHA PL 0008920 VENKATA PHANI RAJ CH GX Voluntary liability notice DHA PL 0008920 VENKATA PHANI RAJ AJA 11 6 Authorization Form Genera The Authorization Form screen contains a user friendly form designed to minimize the user s effort in submitting an Authorization Below is a brief descriptions of the fields found in this form Many fields are populated automatically with suggestions There are 3 sections in this form Patient amp Encounter Information Diagnosis Information and Activities Information
12. cian Start Time 144 11 05 2012 09 22 46 Type Start Type No Bed No emergency room v Elective ProviderLink gt 5 Claim Form Potient 2 Encounter info Encounter Header Information fields Here are the definitions of the fields notice k Pi l as some are mandatory denoted by Encounter ID Is the encounter visit or episode number it will automatically populate as an auto generated one if not filled manually Many use it to track invoices invoice number e Clinician Physician supervising the activities in this encounter the Patient Information fields Name Patient name it doesn t go to payers but stay in system for tracking purposes Patient ID File number Patient file number at the facility it will automatically populate an auto generated one if not entered by user Contact Number Patient phone or mobile number Emirates ID Enter National Emirate ID or select reason if consultation prescribing drugs conduction a procedure or a service If you are a Clinic hospital or optical center then you need to enter all clinicians working at your facility in the system before seeing the clinician name here in the list refer to section 3 on how to add your clinicians Enter few letters of name or license number to choose from list Start Time Encounter Start date and time automatically populated if not available done at time of service e Member ID Card Number Member insurance ID as e
13. d the system will show you a short list of related diagnosis descriptions and codes to select from Be more specific in your search if so many options pop up in the list use other key words to search for The comprehensive list of all CD10 CM codes is available in an excel file for reference in the Support section under Codes Download part Here are the definitions of the fields notice some are mandatory denoted Nonstscose Type Code Description Diagnoses 2 Click to show diagnoses 5 Claim Form Activities Info ees ees Inserted Successfully Code CPT gt Dental D0120 periodic oral evaluation established patient ProviderLink gt Qty Gross Net PtLSh Star 2 Edit Activity Delete Activity 0 00 11 05 2012 10 25 DHA PL 0008986 VIMI PONNAMPARAMBATH 0 Ei Oty Gross Net Patient Share 1 11 05 2012 10 28 DHA PL 0008986 VIMI PONNAMPARAMBATH Activities fields Non Std Code Your non standard service code used by your facility with the payer before eclaims came into picture This is not a mandatory field and can be used till Jan 1 2013 when this field is dropped Currently it s a code that is captured as an observation Type Type of the activity CPT for procedures including operations labs and radiology Dental Drug Service including consultation and HCPCS consumable and disposables Code Description Enter code or search by entering a keyword to search for the needed code or de
14. de is a consultation code 9 9 1 10 10 1 11 11 1 21 22 23 AS soon as the code is entered the system opens the Presenting Complaint Observation box Also similar case happens when Dental code is entered the system opens the Tooth Number Observation Box to enter tooth if it is applicable With rest of Activity code an optional Description Observation Box appears but not mandatory 16 ProviderLink gt 7 Patients Page search and Edit The Patients Screen will allow you to define New Patient or edit existing patient information and allow you to create Encounter for a selected patient It will also provide you with a detailed look on the patient general information and Plan information Ula New Patient Search By General Information Search By Plan Information Personal Information Name Gender Phone Female v Page 1 1 1 Patient Code Patient Name 32 dana test Patient Code Emirates ID Number Search By General Information Next Birthdate Emirates ID 18 05 2012 000000000000000 17 7 Patients Page create New Patient eee r Save Patient New Patient Here are the definitions of the fields i latient Code Name Emirates ID notice some are mandatory denoted 34 Hasan 000000000000000 National without card rthdate Gender Phone by 03 12 1981 v eight Kgs Breast Feeding Weeks Of Pregnancy Creatnine Clearance ml min Select v To Create a New Patient or edit e
15. e When you click on the Send button the system shall update the Submitted column status and Shall inform you if there is an error message coming from dhpo and if unable to upload with excel file containing reason such as clinician license is expired If nothing appears and status of submission becomes Yes then its already submitted You can validate this by checking the dhpo for the file Use the search engine to enter the criteria in which you want to filter your results 1 1 False 01 05 2012 11 23 15 0 3 test False 01 05 2012 11 25 14 0 False 02 05 2012 11 20 51 0 7 False 03 05 2012 11 21 47 0 03 05 2012 16 39 54 Previous Next Page 1 4 36 ProviderLink 10 Claims Page remittance Advices Search Filter Start Time End Time Use the search engine to view all the previously saved Remittances in the system Search result E EA a et To check for new Remittances click on Nos Check for new Remittances button The 06 05 2012 17 41 13 TestClaim2 INS001 system will allow you to download to see it pe ee in xml format or import to include the file 07105 2012 12 50 36 abdtest10 INS001 in the system by clicking on Download or Import buttons Page 1 2 19 07 05 2012 13 14 00 abdtest11 INSOO1 07 05 2012 14 58 32 check1 INSOO1 07 05 2012 16 42 17 check1 INSO01 07 05 2012 17 21 11 checkclaim INS001 07 05 2012 17 57 16 checkclaim INS001 1 2 3
16. e list refer to section 3 on how to add your clinicians Enter few letters of name or license number to choose from list e Show observation observations are not required except in limited cases Check next page for more details about rules related to it The Non Standard Code must be mapped to a specific Activity Type and Code Its important to keep in mind that Gross is always equal or larger than Net Patient Share The comprehensive list of all Activity codes are available in an excel file for reference in the Support section under Codes Download part ProviderLink gt 6 Authorization Form Observations Info Value Type Value Type Observation s are part of activities and are not mandated except in UOde L 0 00 0 00 certain Cases Service 9 Consultation GP Authorization Clinician Presenting Complaint 1 05 2012 15 21 DHA PL 0008920 VENKATA PHANI RAJ CH Observation fields e Type One of the listed types to be selected e Code Value and Value Types vary depending on the Code Description observation type and nature of needed data Payers may aS iaid E B a request specific data to be captured and sent in a special 02 DHA PL 0008920 VENKATA PHAN RAJ CH DHA approved form Enaya programs mandate providers to capture the presenting GX Voluntary liability notice Complaint in observation if the Activity Type is a Service and Clinician DHA PL 0008920 VENKATA PHANI RAJ the Co
17. e the quality of care enhance efficiency and reduce mistakes fraud and abuse in the Emirate of Dubai Visit www eclaimlink ae for more information 1 Getting Started Accessing the eClaimLink system requires that your facility is equipped with a computer and internet connection To get started open your internet browser and navigate to the following website www eclaimlink ae You will be then be directed to the eClaimLink main website On the upper left corner of the website you will find a login form click to register if you are a new user Please enter your username and password if you are already a registered user ProviderLink eClaimLink Home Login User Name gt eClaimLink Password LogIn Click to register forgot password s seeking cost effective quality care aP dpo maaa DHO mone soppon Calendar Latest Updates Medical Coding Training 2 eClaimLink Project Quick update System Training May June 2012 Provider Application Training Registration Effective day for applying eClaims with Enaya Mandatory June 1 2012 eClaimLink Claims Management Awareness Workshop eClaimLink A application 2 Registration If you are a new user to register you need to have a valid license with one of the health authorities or MOH in the UAE Register your licensed facility on eClaimLink by clicking Click to register in the login section on main page If you are part of a group of facilit
18. ere are the definitions of the fields notice some are mandatory denoted by Diagnoses 2 Click to diagnoses Diagnosis Inserted Successfully Code Description Edit Diagnosis Delete Diagnosis A01 00 Typhoid fever unspecified 8 Edit Diagnosis Delete Disgnosis A02 24 Salmonella osteomyelitis Add Diagnosis 3 Secondary v Activities 0 Click to show activities Diagnosis fields Type Primary Admitting or Secondary Only one Primary Diagnosis or Admitting is allowed but can add several Secondary diagnosis Code with Description Enter the ICD10 CM code if you know it or enter key word of the diagnosis description you are seeking and the system will show you a short list of related diagnosis descriptions and codes to select from Be more specific in your search if so many options pop up in the list use other key words to search for The comprehensive list of all ICD10 CM codes is available in an excel file for reference in the Support section under Codes Download part Here are the definitions of the fields notice some are mandatory denoted norsiscove noe Code Description 6 Authorization Form Activities Info Avily Inserted Successfully Code Description CPT gt 11 05 2012 10 28 DHA PL 0008986 VIMI PONNAMPARAMBATH Activities fields Non Std Code Your non standard service code used by your facility with the payer before eclaims came into picture This is not mandatory and can be used
19. ies each of these facilities need to be registered on eClaimLink and the account of the facility you are practicing in should be used Enter all requested info in the form after validation for your ID is done your account Shall be activated and you should receive a notification through the email you registered with Siam Lin ny Home Home Login V User Name Password Click to register fprgot password Sd aah ed aA Subscriptions Finish IE provider payer and your contact information is the proper official eml and phone Account Provider z Type i Facility DHC0006 Testing Pharmacy Username Test User Email test account test com Password ssseess Confirm sseesee Password Contact test contact person Person Phone 000112233456 Continue gt gt Cancel For technical issues with registration please check with Dimensions Healthcare support check contact us page ProviderLink As you are registering on eClaimLink ae site you are hereby confirmifig that you are the authorized person at the selected healthcare eClaimLink A applications 3 Logging In and Setup After logging in from the login section on main page explore the different components of the system by clicking on various buttons on the header menu get familiar with various components of eClaimLink before you start Visit the DHD s section of Data Flow to understand the expected flow for the system Chec
20. k the awareness workshops files on the Info Hub for more details Click on Support and setup your Group Management for your facility groups and their access permissions Click on User Management to add your users and decide to which group they belong If you are a clinic hospital or optical center then click on Clinicians Management to add the physicians who work at your facility Its critical to add all physicians who you will claim for When done click on Applications to login to the ProviderLink application and start entering claims and authorizations ProviderLink gt eClaimLink Login V User Name Password Click to register forgot password amp 2 Home Info Hub DHD Groups Management Users Management Clinicians Management eClaimLink A support ProviderLink gt 4 ProviderLink System After logging in to ProviderLink the Claim Form is automatically activated Get familiar with the menu that you will be using while in the application to fill forms search generate submission files to submit it to the dhpo ST aa Welcome abdelhadii Log Out I z Li kK gt Home Info Hub DHD Applications DHPO Dashboards Support eClaimLin Claim Form Authorization Form Patients Encounters Authorizations Claims Submission Tracking Settings ProviderLink imtis A Patient Information Name Patient ID file number Contact number Emirates ID
21. nce Card plete ate ie AA AUO ON TOA A aa DOLGE e Plan Payer Insurance Company and Plan of the Member some are mandatory denoted by e Date Ordered The date on which the prescription order is Patient amp Encounter Header Information fields prescribed ordered e Code The prior request ID tracking number for request e Name Patient name only for internal tracking not sent to payers e Patient ID File number Patient file number at the facility it will automatically populate an auto generated one if not Save to enter diagnosis and activities entered by user A new sections open for Diagnosis and Activities open to enter the e Contact Number Patient phone or mobile number remaining information e Emirates ID National Emirate ID or select reason if not available After finish entering the Patient and Encounter Information click button of Claim Form uth orizatio orm Patients icounters inorizations aims Submission Tracking Settings roviger _ink Patient amp Encounter Authorization Type Encounter Type Code Date Ordered DD MM YYYY Authorization o Bed No emergency room DHA FL 0034467 201205112001 11 05 2012 P atic Batient ID file number Contact number Emirates ID Emirates ID not available select reason x PI Member ID Card number an Payer Fr Ry Pa OR Sate ee Seo Continue to fill diagnoses amp activities 13 ProviderLink 6 Authorization Form Diagnosis info H
22. scription Quantity The number of Activities served It can be also a fraction such as half a pack of drug Gross Is the total AED amount of the charges included on the Activity Net The net charges billed by the provider to the Payer for this Activity Patient Share Any fee the provider have effectively collected from the patient for this activity Activities fields e Start Insurance Company and Plan of the Member e Authorization ID The ID number given by the payer for authorizing the activity e Clinician Is the same Clinician ID entered in Encounter Information section before no need to change unless needed for this specific activity e Show observation observations are not required except in certain cases Check next page for more details about rules related to it The Non Standard Code must be mapped to a specific Activity Type and Code Its important to keep in mind that Gross is always equal or larger than Net Patient Share Authorization ID is not mandatory if you got it from payer by e Authorization phone or fax enter it here The comprehensive list of all Activity codes are available in an excel file for reference in the Support section under Codes Download part 5 Claim Form observations Info Observation s are part of activities and are not mandated except in certain cases 1 05 2012 15 21 Observation fields e Type One of the listed types to be selected e Code Value and Value
23. till Jan 1 2013 when this field is dropped Currently it s a code that is captured as an observation Type Type of the activity CPT for procedures including operations labs and radiology Dental Drug Service including consultation and HCPCS consumable and disposables Code Description Enter code or search by entering a keyword to search for the needed code or description Quantity The number of Activities served It can be also a fraction such as half a pack of drug Gross Is the total AED amount of the charges included on the Activity Net The net charges billed by the provider to the Payer for this Activity Patient Share Any fee the provider have effectively collected from the patient for this activity Dental D0120 periodic oral evaluation established patient ProviderLink gt Diagnoses 2 Click to show diagnoses Activities 1 Click to show activities Qty Gross Net PtLSh Star Edit Activity 0 00 11 05 2012 10 25 DHA PL 0008986 VIMI PONNAMPARAMBATH 0 4 Oty Gross Net Patient Share 4 Activities fields e Start Insurance Company and Plan of the Member e Clinician Physician supervising the activities in this encounter the consultation prescribing drugs conduction a procedure or a service If you are a clinic hospital or optical center then you need to enter all clinicians working at your facility in the system before seeing the clinician name here in th
24. view details of already submitted requests click on the needed line Claim Form Authorization Filter Search Code ID Member ID Card number Result received Al Yes No Pending Pending Pending Pending Pending Pending Pending Pending Pending Member 1234554321 AHM21 0004145 AHM21 3543 Patients Encounters Date Ordered From Plan Payer Code DHA FL 0034467 201205071645 DHA FL 0034467 201205071644 DHA FL 0034467 201205071158 DHA FL 0034467 201205061042 DHA FL 0034467 201205052202 DHA FL 0034467 201205051508 DHA FL 0034467 201205030944 DHA FL 0034467 201205022317 DHA FL 0034467 201205021615 Authorizations Date Ordered To Payer INSOO1 INSOO1 INSOO1 INSOO1 INS001 INS001 INS001 INS001 INS001 Claims Plan ubmission Tracking Settings Patient Name Authorization Type lt lt Select gt gt PR TransactionDate PA TransactionDate 07 05 2012 16 45 07 05 2012 16 45 07 05 2012 12 00 06 05 2012 10 43 05 05 2012 22 03 05 05 2012 15 11 03 05 2012 09 45 02 05 2012 23 22 02 05 2012 16 15 Type Eligibility Eligibility Eligibility Eligibility Eligibility Eligibility Authorization Authorization Authorization 21 ProviderLink S piicstion 10 Claims Page submissions Submissions List The Claims Page is where you will send and S review status of submissions we t r ClaimlId Claim Code Submitted Transaction Date Encounters Count Send To Post Offic
25. xisting ones you will need to 1 Enter patient Name ember ID Plan Payer Expiry Date 2 Enter Emirates ID If the Emirates ID is not available select a reason enayaA P0001 Category A NS001 D ZMH Save Patient Plan New Patient Plan 3 Enter Birth Date 4 Select Gender 5 Enter Phone Number 6 Click on Save Patient button Rest of Information is not important for claims and follow up Patient Insurance Plans you will need to 1 Enter Member ID 3 Select Plan Payer The Plan Payer is a smart list Enter the first 2 or 3 letters of the plan payer name or code and the system will show the matching records 4 Enter Expiry Date 5 Click on Save Patient Plan 18 8 Encounters Page search and Edit To view encounters navigate to the Encounter Page In this screen you will be able to view all generated encounters in details Use the search engine to enter the criteria in which you want to filter your results If you desire to view all encounters leave all fields empty and click on search You may also Edit or Delete previously entered encounters by clicking on Edit or Delete buttons Search Filter Encounter Code Start Time Start Type Insurer Search result x Patient Code Any 2s z Member Card Select Insurer Encounter Type Any End Time End Type Select End Type z Plan
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