Adjudication Prerequisites

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Prerequisites

This chapter assumes the HIPAA Claim Master and HIPAA Claim Payment Master are both installed and configured. Claims imported to the Claim tables (using the HIPAA Claim Master or otherwise) will be adjudicated through the HIPAA Claim Payment Master.

Of note are the claims tables need the Claim Feedback fields which are commented by default.

adjClaimFeedbackFields
Table Creation window in HIPAA Claim Master. The claim feedback fields are currently commented and are ignored when executing the script.

To add these fields to an existing table easily, remove the dashes placed in front of each claim feedback field (--), click Save, then click Compare Script with existing Table, and run the resulting script for both the Claim table and the Claim Detail table.

The fields configuration must also include the Claim Feedback data fields. They are grayed out and not selected by the Select All button.

adjClaimFeedbackFieldsConfig
Detail of field configuration screen in HIPAA Claim Master. The gray Claim Acknowledgment fields are displayed.