189 Bupa Claim Management

08/02/2021 To send and validate the information of the patient accounts to the Bupa system before generating the claim

 

On this function you can do the following functions:

1. Submit to validate patient account information.

2. Tracking accounts ready to generate the claim.

3. The follow-up to accounts that require completing the information.

They are run by people of different roles, but you can learn everything about this option in this article.

Workflow

How to use it?

To submit account information for validation, the account must have the following:

1. Have finished the coding by H.I.M staff and have the Complete check-marked ( Abstracting option).

2. Have at least one receipt note created (processed) with all approved charges and amounts greater than 0.

   Follow the steps in the video to submit account information.

 

 

What you should know?

Settings

1. Request to ECS Support the connection with the Bupa system.

Important rules

1. In this function, you will see all patients who have Bupa insurance.
2. When you receive the Bupa claim id It means that the information of the patient account is validated and ready to generate the claim. And Complete state is reflected in Bupa status column.
3. When you receive a warning in response, the status that is reflected is Error in Bupa status column.
4. You will see the post date displayed.

Additionals functions

1. Consult or filter through the following fields.

2. Print the filtered information.

3. Go to Abstracting option to conclude and complete the coding.

Relates options

1. Abstracting

2. Multibilling

3. Patient registration

Relates reports

N/A

Warnings

1. Message: The claim request could no be ended...

        Where: Main window.

        When: Click on Send claim to Bupa button.

        Why: The account status is Not coded.

        Action: Confirm coding has been done and marked as completed.

 

2. Message: Member does not exist. At least one claim line input is required.

    Where: Main window.

    When: Click on Send the claim to Bupa button.

    Why: Policy member ID is required and has at least one receipt note created.

    Action: Fill in the Member ID field in Patient Record / Insurance Information and create at least a receipt note

We are excited to enhance your experience at Cirrus. We appreciate that you share this information with your team and request help through our chat if you need it.

Date: August 5, 2021