When to create a manual claim
Most claims come into Billing automatically when you import patient care reports from CloudPCR. But sometimes you need to create a claim by hand:
- The run was documented on paper or in another system, not in CloudPCR.
- You need to bill for a service that does not have a matching patient care report.
- You are entering a historical claim from before your agency started using CloudPCR.
Before you start: You need an agency selected and edit access. Without both, the New Manual Claim button does not appear.
How to create one
- From the menu, click Claims.
- Click the New Manual Claim button in the top-right corner.
- The claim opens with the message "This is a manual claim. Start by searching for an existing patient or add a new one." Click Search to find an existing patient, or Add New to create one.
- Once a patient is linked, the claim form appears with seven sections: Claim Info, Patient, Payers, Transport, Coding, Charges, and Attachments.
- Work top to bottom, starting with Claim Info: enter the incident number and date of service, then click Billing Provider to confirm the place of service and provider details.
- Fill in the Patient section, add one or more payers, enter pickup and destination details in Transport, add diagnosis and transport reason codes in Coding, review the Charges, and upload any Attachments you need.
- Your changes save automatically as you go.
Tips
- You do not have to fill in every section in one sitting. Come back later and pick up where you left off.
- Click Validate Claim in the right-hand panel after filling in the claim to catch any missing or incorrect information before you submit it. See Claim validation.
- Manual claims go through the same QA checks as imported claims. If something trips a rule, a flag badge appears on the claim's row in the claims list and on the Quality Audit page. See QA flags on a claim.
- Once the claim is submitted, it goes out with your next transmit like any other claim. See Transmitting claims.