Service Line(s)

A Service Line is listed on a claim for each procedure or item that is to be reported to the Payer(s) for claim adjudication. Each claim must contain at least one Service Line.

The main view of the Service Line(s) tab contains the basic information for the line as it relates to NY Medicaid. Additional information and adjudication details from Other Payers are available on subsequent pages. As a default, 5 Service Lines are displayed on the main page, however you may add as many as needed, up to a maximum of 999, simply by clicking Add More Service Lines. You may remove any single Service Line by clicking the Remove icon on that line. In addition, the total of all the submitted charges for the Service Lines is listed below all the Service Lines that have been entered.

Line: This is a system generated value to uniquely identify the Service Line on the claim. The counter will start with 1 and increment with each new Service Line entered. A minimum of 1 Service Line is required on all claims.

Line Item Ctl#: This field can be used to enter a line number that corresponds with your records if it is different than the line number given. When used, the value provided will be returned on the 835 (electronic remittance advice) and may be used as an index to your system. This field is not required.

Date of Service: For a procedure/service rendered on a single date, enter this date in the From Date. However, if the procedure/service transpired over a period of time, enter the start and end dates in the From and To fields respectively. The date(s) may not be greater than the current date. The format is: MM/DD/YYYY and may either be entered in the field or selected from the calendar available by pressing the button to the right of the field.

Rev Code: The Revenue code associated with the procedure/service. This value is required and will be validated against the Revenue Codes in the database.

Proc & Mod: The Health Care Financing Administration Common Procedural Coding System identifier for the product/service. This code value is required for all Outpatient Claims. Optionally, up to four modifiers identifying special circumstances related to the performance of the service may be entered for each code. Note: If entered, the Modifier must be a 2 character code.

Charge Amount: The submitted charge amount for this procedure/service must be entered. Note: Zero dollars is a valid charge amount.

Service Count: The number of days or units in which the procedure/service is to be billed. A drop down is available to indicate the unit of measure for the Service Unit. Valid units of measure are 'Units' and 'Days'.

Total Claim Charges: At the bottom of the table of Service Lines, all charges for all Service Lines on the claim will be summed and displayed, once the Service Line Information is saved.

For each Service Line, you may view/enter additional details by clicking the More icon. However you may only view these additional details once all required elements have been entered. Navigating off this summary page, either by clicking the More icon or moving to another tab, will trigger validation of the data entered on this page. Validation is done one line at a time, so if there are errors on multiple lines you will have to fix each line before seeing the next set of errors. If a Service Line must be removed for any reason, clicking the Delete icon will remove the line and re-sequence the remaining Service Lines.