Navigation:  Claim Adjudication > Claim Level Adjudication

To make adjustments at the claim level, click the Adjust button in the Claim Level Adjustments, highlighted below.

 

 

The Claim Level Adjudication screen is shown. Adjustments at the claim level can be made here.

 

 

Claim Level Adjustments

To add a claim level adjustment, first fill in the Adjustment Reason Group, Adjustment Reason and enter either a deduction amount or percentage, then click Add.

 

 

To remove an adjustment, select the adjustment in the adjustments table and hit the Delete key.

 

 

Claim Level Statuses

Remember that you can automatically assign a claim status upon adjudication. Please refer to the Default Settings. To add a claim level status, first select the Claim Status Category and Claim Status desired, then click the Add button.

 

 

To delete a claim status, select the claim status in the claim status table and hit the Delete key.

 

 

Claim Level Supplemental Amounts and Supplemental Quantities

The second tab in the Claim Level Adjudication screen contains tables for adding or removing supplemental information.

 

 

To add a supplemental quantity or supplemental amount, first fill in the type of amount or type of quantity, then fill in the amount or quantity, and click the Add button.

 

 

To remove a supplemental amount or quantity, select the row in the appropriate table, then hit the Delete key.

 

 

Saving Adjustments

To save any adjustments made to the claim, click the Save button on the lower left. All the adjustments will be saved and the new balances will be reflected in the main claim adjustments screen.