EZ 2000 Manual - Claim, Medical Tab

Claim - Misc Tab

The Misc tab on the Edit Claim window has many fields that are used rarely.

Correction Type:  Used to fix mistakes in e-claims which have already been sent. This feature was added for Denti-Cal direct integration, but can be used for other carriers as well. The possible correction types are Original, Replacement, and Void.
- Original:  Use Original for the first submission of any e-claim.  
- Replacement:  If you realize after submitting an e-claim that some of the reported information is incorrect, then you can send the e-claim again, but with correction type Replacement. The carrier will ignore the original claim and instead use the new replacement claim. Each carrier has their own policy on whether or not they accept replacement e-claims and what kinds of corrections they will allow in replacement claims. You need to call each carrier to see what their policies are.
- Void:  If an e-claim was sent entirely in error, you can resend the e-claim with correction type Void, which will cancel the original claim. Most carriers do not support this correction type.
Both Replacement and Void claims should be sent as soon as possible after the original claim is sent, in order to improve the chances of acceptance.

Prior Authorization (rare):  Tyically used for medical claims.  Shows on printed and E-Claims.  On printed claims, the number shows in the PriorAuthorizationNumber field.

Special Program: Only used for e-claims with the 5010 electronic format.  This is sent on preauthorization e-claims when the value is set to a something other than none.

Claim Identifier (CLM01):   A unique identifying number for each claim. EZ automatically generates this number using the format PatNum/ClaimNum. It can be manually edited when creating the claim, but once the claim is saved it cannot be changed.  It is used to match an electronic EOB to the original claim.  See E-Claim Complexities. 

Original Reference Num: Required by Medicaid when voiding a claim or replacing a claim by setting the CLM05-3. See E-Claim Complexities.

Custom Tracking: Use to record custom data related to the claim. The options in the dropdown can be customized in Definitions under Claim Custom Tracking. Does not show on printed claims or e-claims.