Claim Rules

• Claim Rule: Setting Claim Rule Conditions
• Claim Rule Overview and Ordering

• Service Grouping Claim Rules
• Service Grouping Rule - Changing Claim Form Type
• Service Grouping Rule - Set Service Billing Profile for Current Sequence Payer
• Service Grouping Rule - Adding Patient Condition Codes

• Claim Line Item Rule - Adding Modifiers
• Claim Line Item Rule - Adding Rendering Provider Modifiers
• Claim Line Item Rule - Using Rendering Provider as Rendering Provider Name and NPI
• Claim Line Item Rule - Using Practice Billing Entity as Rendering Provider Name and NPI

• Claim Form Rule - Add Occurrence Codes to Institutional Claims
• Claim Form Rule - Changing Bill Type Prefix
• Claim Form Rule - Change Bill Type Suffix to 0 For Nonpayable
• Claim Form Rule - Change Bill Type Suffix to 1 for Admit thru Discharge
• Claim Form Rule - Update Bill Type Suffix to 2 for First Interim Claim
• Claim Form Rule - Update Bill Type to 2/3/4 for First/Continuing/Last Interim Claim

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