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| SAMPLE REPORTS |
nhxsPricer offers a robust set of reports and business intelligence tools, of which the following are only a few examples. For a full product demonstration of nhxsPricer, please contact us today.
Entering Claims into nhxsPricer
Electronic Claims: The transaction set for nhxsPricer batch claim data is the ASC X12N 837 (v4010 or higher) file, which contains all of the necessary data to processthe claim for real time adjudication. These files are transmitted through a secure connection and then the explanation of review (EOR) is returned which is then used to load any contractual allowances and bill the patient responsibility.
Manually Entered Claims: Manually entered claims are entered using a web-based application designed to replicate an enhanced CMS 1500 claim form. There are a few required fields in the 837 files that are not available on the CMS 1500 (i.e. Claim Filing Indicator (PPO, EPO, HMO), etc.). The Claim Filing Indicator has been added by NHXS to the online CMS 1500 form. Required fields are highlighted to speed data entry. Claims with more than six services can be entered into a single claim.
View sample report [PDF].
Errors
In order to help protect against key stroke errors that could affect the pricing of the claim, the procedure, modifier, and diagnosis code(s) are validated. If any of these are invalid for the date of service, a Red Alert will be returned when you attempt to price the claim.
View sample report [PDF].
Patient Responsibility Calculator
The Patient Calculator is accessed through a link in each EOR. The user enters a patient’s deductible, coinsurance and co-payment amounts to calculate patient responsibility. Statements may be adjusted to reflect any payments at the time of service and a copy may be printed for the patient’s records.
View sample report [PDF].
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