help_bullet_title.gif Service Line Adjudication Summary

If there are multiple Other Payers defined for a claim, each Service Line may have multiple Line Adjudication records. Viewing the Line Adjudication Summary for a particular Service Line will provide quick visibility to the payments which have been made against the particular Service Line.

From this page, you may Add Another Line Adjudication or review the individual Line Adjudications. The table displayed contains the following summary information:

Line #: An incremental counter to track the adjudication records for each line.

Other Payer Name: The Third-Party or Managed Care payer responsible for payment on this claim. All subsequent data entered applies to the Adjudication for this Service Line and Payer combination. Any Payer entered here must also be entered on the Other Payer tab for the claim.

Service Line Paid Amount: The dollar amount paid towards this Service Line by the Payer. The total of all the Service Line Paid Amounts on this claim must add up to the total Other Payer Paid Amount on the Other Payer tab.

HCPCS Code: The Health Care Financing Administration Common Procedural Coding System identifier for the product/service. This code value is required for all Outpatient Claims.

Date Claim Paid: Service adjudication or payment date. The format is: MM/DD/YYYY.

Remove a Line Adjudication

Clicking the Remove icon for a particular Line Adjudication record will prompt you to confirm the deletion. Removing a record will permanently delete the data from the claim and adjust Line Paid amounts accordingly.

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