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.
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.
- Place of Service — either 41 - Ambulance (Land) or 42 - Ambulance (Air or Water).
- Provider Signature — whether the attending provider has signed off on the patient care report. Some payers require this before they will process the claim.
- Billing Provider — the name, NPI, tax ID, taxonomy, and mailing address that identify your agency on the claim. These usually come from your location's settings.
- Accident & Workers Comp — click this button if the call was related to an accident. You can mark it as Employment (Current or Previous), Auto Accident, or Other Accident, and enter the accident state and country.
Example
A call came in on March 15. The incident number is 2026-00412. It was a ground ambulance transport, and the patient was injured in a car accident. You would enter the date, type in the incident number, select 41 - Ambulance (Land) for place of service, 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.
- If the related cause is an auto accident, some payers will ask for the state where the accident happened. Fill in that field while you have it.