What this section is for

The Claim Info section holds the basic facts about the call. This information identifies the claim and sets the context for everything in the other sections. To get there, open a claim from the claims list; Claim Info is the first section on the form.

Fields in this section

  • Incident / Patient Control Number - the unique number assigned to this call. If the claim was imported from CloudPCR, this is filled in automatically.
  • Date of Service - the date the call happened.
  • Claim Frequency Code - pick 1 - Original (Admit thru Discharge) for a first-time claim. Pick 7 - Replacement or 8 - Void/Cancel when you need to correct or cancel a claim the payer already has. When you pick 7 or 8, enter the payer-assigned ICN from the ERA or EOB in the Original Claim ICN field that appears.
  • Transaction Type - CH - Chargeable for a normal billable claim. RP - Reporting is for report-only submissions.
  • Provider Signature - whether the attending provider has signed off on the patient care report. Some payers require this before they will process the claim.
  • Provider Signature Date - fills in automatically when you set the date of service. Change it if the provider signed on a different day.

The Billing Provider button

Click Billing Provider to open a window with the details that identify your agency on the claim:

  • Place of Service - either 41 - Ambulance (Land) or 42 - Ambulance (Air or Water).
  • Provider Accept Assignment - whether your agency accepts the payer's allowed amount as payment in full.
  • The Name, NPI, Tax ID, Taxonomy, address, and mailing address for your agency. These usually come from your location's settings.

Click Save to close the window and keep your changes.

Accident details (auto accident, workers' comp) are not in this section. They are entered in the Coding section via the Accident & Workers Comp button.

Example

A call came in on March 15. The incident number is 2026-00412. You enter the date and incident number, then click Billing Provider and confirm 41 - Ambulance (Land) as the place of service. Because the patient was hurt in a car accident, you later open the Coding section, click Accident & Workers Comp, and choose Auto Accident.

Tips

  • Double-check the date of service. A wrong date can cause the claim to be denied.
  • Leave the Claim Frequency Code at 1 - Original (Admit thru Discharge) unless you are replacing or voiding a claim the payer has already received. Sending a replacement for a claim the payer never accepted just confuses things.