Claim Info is where you enter additional information that may be required to accurately submit a claim, such as the patient’s initial treatment date, onset date, or accident information. This information can be entered by either the provider or biller and is included on the electronic or paper claim when applicable. The fields you need to complete will depend on the patient’s circumstances, the services being billed, and the requirements of the applicable payor.
This article will walk you through entering Claim Info into ChiroUp.
⭐️ Who enters Claim Info & where?
Claim Info can be entered by either the provider or the biller.
How Providers can enter Claim Info
Directly from the encounter, click Claim Info.
After entering the applicable Claim Info, choose whether to save the information for this encounter only or update the patient’s record:
- Save for This Encounter: Saves the information only for the current date of service. It will not be applied to any other past or future dates of service.
- Update the Record: Saves the information to the patient’s record so it will apply to future dates of service and to past dates of service for which a claim has not yet been submitted. Claims that have already been submitted will not be updated.
How Billers can enter Claim Info
Billers can update Claim Info in two places: the patient’s Insurance tab or directly on the claim.
1. Insurance Tab:
The Insurance tab stores the patient’s primary Claim Info record, which automatically populates newly created encounters.
Continue to the following sections to learn how the primary Claim Info record compares to Claim Info saved for individual dates of service.
- 💡If a patient has multiple Tracks, you'll see multiple Claim Info records: one for each track, and one for no-track encounters.
2. Claim:
Update Claim Info for an individual date of service from the claim directly. Just click Edit under Additional Claim Info!
After entering the applicable Claim Info, choose whether to save the information for this encounter only or update the patient’s record:
- Save for This Encounter: Saves the information only for the current date of service. It will not be applied to any other past or future dates of service.
- Update the Record: Saves the information to the patient’s record so it will apply to future dates of service and to past dates of service for which a claim has not yet been submitted. Claims that have already been submitted will not be updated.
⭐️ What's the difference between updating the Claim Info record vs For this Purchase only?
The Claim Info record in the patient’s Insurance tab is the primary record. It automatically populates future purchases and existing encounters whose claims have not yet been submitted, provided their Claim Info is not locked.
Updates to this record apply to future purchases and existing encounters with unlocked Claim Info.
❓What does it mean for Claim Info to be “locked?”
- An encounter’s Claim Info automatically locks when either of the following occurs:
- The claim has been submitted
- You select Save for This Purchase Only when saving Claim Info.
- A locked encounter’s Claim Info can still be edited. However, because the Claim Info is “Locked” changes made to the primary Claim Info record in the patient’s Insurance tab will no longer automatically update that encounter.
- Once a claim has been locked, it cannot be unlocked. Updates to that claim's Claim Info must be done individually either from the encounter or claim itself.
⭐️ How do I correct Claim Info for multiple rejected claims?
When you have claims that have been rejected for incorrect or missing Claim Info, you'll need to update these claims individually, as they can no longer be updated automatically according to the primary record, as the Claim Info locks after you initially submit a claim. This means that the claim stops automatically updating according to updates made to the primary Claim Info record.
You can update Claim Info individually from the claim directly or from the Claim Info button in the corresponding encounter.
Regardless of where you access Claim Info, the process will be the same. However, we recommend a slightly different workflow depending on whether your changes apply widely moving forward, or just for certain dates of service.
If the changes you're applying to Claim Info will apply to all claims moving forward:
1. Open Claim Info for any impacted date of service and make your changes to the Claim Info and select to Save and update Record. This will update all new claims created for future visits.
2. Open Claim Info for all other dates of service that need to be corrected. Click to Sync from record.
- Because a claim has already been submitted for this date of service, the Claim Info is “locked” which means it will no longer auto-update when the primary Claim Info record updates.
- Click to Sync from record to update Claim Info for this particular date of service according to the current record.
3. Repeat for all impacted dates of service.
If you only need to change Claim Info for these specific dates of service:
1. Open Claim Info for any impacted date of service and make your changes to the Claim Info and select to Save for this purchase only. This will update Claim Info only for this date of service and not impact any other existing or future claims.
2. Repeat for each impacted date of service. Remember to Save for this purchase only if you don't intend for these changes to update future claims.
⭐️ Can I update Claim Info across multiple encounters before submitting claims?
Yes! As long as the encounter’s Claim Info is not locked, updating the patient’s primary Claim Info record in the Insurance tab will automatically update all eligible encounters. No need to update each one individually!
💡 Claim Info locks when a claim is submitted or you save Claim Info for an individual date of service. Updates to the primary record will also carry forward to future encounters.
⭐️ How does updating Claim Info work when there are multiple tracks?
When a patient uses Tracks, there will be a separate Claim Info record for each track. There will also be a record designated for any encounters not on a Track.
⭐️ How do I control which Claim Info record shows in my Patient Info Bar?
If a patient has multiple Tracks (and therefore multiple Claim Info records), then you can pick which record appears in your Patient Info Bar selecting Show for that record.
Click for a breakdown of which Claim Info fields populate each box on claim forms.
- Nature of Condition
- CMS 1500: n/a
- 837: Loop 2300, CR208
- Onset of current symptoms or illness
- CMS 1500: Box 14 - Qualifier 431
- 837: Loop 2300, DTP03 - Qualifier 431
- EPSDT Referral
- CMS 1500: Box 24H
- 837: Loop 2300, CRC03
- Acute Manifestation of a Chronic Condition
- CMS 1500: Box 15 - Qualifier 453
- 837: Loop 2300, DTP03 - Qualifier 453
- Property & Casualty First Date of Contact
- CMS 1500: Box 15 - Qualifier 444
- 837: Loop 2300, DTP03 - Qualifier 444
- Initial Treatment
- CMS 1500: Box 15 - Qualifier 454
- 837: Loop 2300, DTP03 - Qualifier 454
- Last X-Ray
- CMS 1500: Box 15 - Qualifier 455
- 837: Loop 2300, DTP03 - Qualifier 455
- Latest Visit or Consultation
- CMS 1500: Box 15 - Qualifier 304
- 837: Loop 2300, DTP03 - Qualifier 304
- Report Start
- CMS 1500: Box 15 - Qualifier 090
- 837: Loop 2300, DTP03 - Qualifier 090
- Report End
- CMS 1500: Box 15 - Qualifier 091
- 837: Loop 2300, DTP03 - Qualifier 091
- Dates Patient unable to work
- CMS 1500: Box 16
- 837:
- Start Date: Loop 2300, DTP03 - Qualifier 297
- End Date: Loop 2300, DTP03 - Qualifier 296
- Disability Dates
- CMS 1500: n/a
- 837:
- Start Date: Loop 2300, DTP03 - Qualifier 314
- End Date: Loop 2300, DTP03 - Qualifier 360
- Both: Loop 2300, DTP03 - Qualifier 361
- Hospital Dates related to current services
- CMS 1500: Box 18
- 837:
- Start Date: Loop 2300, DTP03 - Qualifier 435
- End Date: Loop 2300, DTP03 - Qualifier 096
- Provider Details
- CMS 1500: Box 17
- 837:
- Rendering: Loop 2310A, NM - Qualifier 82
- Ordering: n/a
- Supervising: Loop 2310A, NM - Qualifier DN
- Condition Related To: Employment
- CMS 1500: Box 10a
- 837: Loop 2300, CLM11
- Condition Related To: Auto Accident
- CMS 1500: Box 10b
- 837: Loop 2300, CLM11
- Condition Related To: Other Accident
- CMS 1500: Box 10c
- 837: Loop 2300, CLM11