Claim Details

1. Click the Claims button on the Accuro Navigation bar.

2. Click to select the tab containing the claim.

3. Right-click on the appropriate claim and select Claim Details from the list displayed.

4. Complete the Claim Form as required.

Completing the Claim Details Form (ON)

Complete the Claims Window

1. If a claim has been opened from an appointment, the patient is already loaded. If you are creating a new bill from Daily Claims, select the correct patient using the Search Tool.

2. Check the patient details are correct.

3. Check the Date of Service and the Provider are correct.

4. Click the Ellipses button  and change or add a Referred By, if required.

5. Click the Add button to add a procedure and any necessary sub-procedures for the claim.

Add a Procedure

1. Double-click the space below Procedure and type in a procedure code or keyword.

2. Select the procedure from the list displayed.

3. Double-click on the space below Diagnosis and type in a diagnostic code or keyword.

4. Select the diagnosis from the list displayed.

5. The other fields auto calculate based on the procedure and diagnosis codes selected.

Add a Sub-procedure

1. Click the Add button to create a new procedure line.

2. Follow the steps for adding a procedure above.

3. Complete the claim details.

4. Click the dropdown list  and select an Insurer from the list displayed.

5. Select a Start Time and End Time, if required.

6. Click the dropdown list  and select a Pract # from the list displayed.

7. Click the dropdown list  and select a Speciality from the list displayed.

8. Click the dropdown list  and select a Master Number from the list displayed.

9. Click the dropdown list  and select a Location from the list displayed.

10. Click the dropdown list  and select a Suffix from the list displayed.

11. Double-click the Admission Date field and select an admission date from the calendar displayed.

12. Click the dropdown list  and select a Percentage from the list displayed, if different from the default.

13. Type in an Internal Note, if required. This is a note for your office and is not transmitted with the claim to the insurer.

14. Click Save to save your changes.

Additional Information

Use the Additional Information area of Claim Details to add any additional information, if required.

1. Click the Additional Information tab.

2. Click to select the Manual Review checkbox, if required.
   Note: If Manual Review is selected, click the Paper button to access the Manual Review form.

3. Click to select the Laboratory Claim checkbox, if required.

4. Click to select the No Show checkbox, if required.

5. Click to select the No Charge checkbox, if required.

6. Click to select the Resubmit checkbox, if this claim is being resubmitted.

7. Type in the Group Number/Laboratory Licence Number/ Independent Health Facility Number, as applicable.

8. Type in the Referring Laboratory Licence Number, as applicable.

9. Click to select the Eligible for Youth Age-Based Fee Premium checkbox, if required.

10. Click to select the Custom Bill Amount checkbox, if required.

View a Claim's History

1. Click the Claims button on the Accuro Navigation bar.

2. Click to select the tab containing the claim.

3. Right-click on the appropriate claim and select Claim History from the list displayed.

Logged Bill History

1. Click the Claims button on the Accuro Navigation bar.
2. Click the appropriate tab, this option is available on all tabs in the Claims section.
3. Right-click on the appropriate claim and select Logged Bill History.
4. Double-click the Date Range and select the to and from dates from the calendar displayed.
5. Click the dropdown list  and select the Activity from the list displayed.
6. Click the dropdown list  and select the User from the list displayed.
7. Click the dropdown list  and select the Provider Name from the list displayed.
8. Click the dropdown list  and select the Role from the list displayed.
9. Double-click a specific log entry to view the details. Click Close when finished viewing the information.
10. To print the complete log summary, click the Print button . The Log Summary window is displayed.
11. Click the Print button .
12. Select the appropriate printer and click OK.
13. When finished with the Log Viewer window, click Close.

Setting a Claim to No Charge, No Show, Adjust-to-Paid, Write-Off

No Charge: is used for anything that was billed incorrectly or for a service the Provider does not want to charge.

No Show: is used when a patient does not show for their appointment.

Adjust-to-Paid: is used for any overpayments or underpayments. It assumes the amount paid is correct and adjusts the billed amount to the paid amount.

Write-Off: is for claims that should have been paid, but have not. A Write-Off report can be submitted for tax purposes at year end.

1. Click the Claims button on the Accuro Navigation bar.
2. Click to select the appropriate tab.
3. Right-click on the appropriate claim and select Options from the list displayed.
   
   Note: On some tabs you may not need to select Options.
4. Select one of No Charge, No Show, Adjust-to-Paid, or Write-off, as appropriate. The claim is updated based on the selection made.
   
   Note: If you select either Write-off or Adjust-to-paid, you will be prompted to select a reason.

Viewing a Claim's Associated Appointment

If a claim was made from an appointment in the Scheduler, you can quickly view that appointment.

1. Click the Claims button on the Accuro Navigation bar.
2. Click the Unsubmitted Claims tab.
3. Right-click on the appropriate claim and select View from the list displayed.
4. Click Go To Appointment. The Scheduler opens at the appointment that created the selected claim.

Remittance Advice Inquiry

1. Click the Claims button on the Accuro Navigation bar.
2. Click the Daily Claims tab.
3. Right-click on the appropriate claim and select Generate from the list displayed.
4. Click Remittance Advice Inquiry.
   
   Note: If there are no claims with remittances to generate inquiries for, an appropriate message is displayed.

Marking a Claim for Resubmission (ON)

Any claims that are returned to Not Reconciled may be adjusted and then marked for resubmission.

1. Click the Claims button on the Accuro Navigation bar.
2. Click to select the Not Reconciled tab.
3. Right-click on the claim being marked for resubmission and select Resubmit.
   
   Note: You can also select Resubmit All to to mark all the claims for resubmission.

Set Tracking Pin

Assigning a tracking pin is an easy way to mark a specific claim of interest. All claims with tracking pins attached can be viewed on the Tracked Claims tab.

1. Click the Claims button on the Accuro Navigation bar.
2. Click the appropriate tab.
3. Right-click on the appropriate claim and select Set Tracking Pin from the list displayed.
   
   Note: Set Tracking Pin is only displayed in the right-click list if at least one tracking pin exists.
4. Select the pin from the list displayed. The tracking pin is now attached to the selected claim.

Clear Tracking Pin

1. Click the Claims button on the Accuro Navigation bar.
2. Click the appropriate tab.
3. Right-click on the appropriate, select Set Tracking Pin from the list displayed.
4. Click None. The tracking pin has been removed from the selected claim.

Resubmit All

Once all claims are complete and ready to be submitted, they can all be submitted together rather than having to process each one individually.

1. Click the Claims button on the Accuro Navigation bar.
2. Click the Day Claims or Unsubmitted Claims tab.
3. Right-click on any claim and select Submit All from the list displayed.

Submit Claims

1. Click the Claims button on the Accuro Navigation bar.
2. Click the Daily Claims or the Unsubmitted Claims tab.
3. Once all claims are ready to be submitted, click the Submit Claims button located at the bottom-right of the window.
4. If a Submission Warnings window is displayed, items listed in the warning need addressing before the submission can proceed. Claims that do not have warnings can be submitted, leaving behind those that have warnings to be corrected.

Accept Response

1. Click the Claims button on the Accuro Navigation bar.
2. Click the Daily Claims, Unsubmitted Claims or Not Reconciled tab.
3. Right-click on the appropriate claim and select Accept Response from the list displayed.