Institutional Claims Institutional ClaimsThe process of entering an Institutional Claim is simplified by the user-friendly tab layout of the pages, grouping data elements to be entered into logical sets.
The tabs of information are as follows:
General Claim Information: The General Claim Information tab is identical for all Claim Types. It contains client specific information for the claim, and once data has been entered, is view only as the client personal information may not be modified.
Institutional Claim Information: This tab is specific to Institutional Claims. Just over half the data elements included on this page are unique to Institutional Claims.
Provider Information: All information pertaining to the Attending, Operating, or Referring Physician is entered on this tab.
Diagnosis/Procedure: Diagnosis and Procedure codes are entered here to allow charges to be properly assigned. Multiple diagnosis codes and multiple procedure codes may be entered.
Other Payers: The Other Payer tab allows for the entry of payers and the related subscriber information who, in addition to NY Medicaid, are responsible for the payment of the claim being entered.
Service Line(s): Multiple Service Lines may be entered to provide detailed information regarding the services rendered and associated with this claim.
