Converting Professional Claims to Institutional Claims in Billing Manager

1. Deleting the Professional Secondary Claim

To convert a professional claim to an institutional claim, begin by deleting the professional secondary claim. First, go to Billing, then Claim Processing. Next, update the search criteria by specifying the date range, record type as Pre Claims Check, claim type as Secondary Claims, billing entity, and facility. Click View, then copy the claim number of the claim you need to delete. Finally, select the checkbox next to the Date of Service.

2. Deleting the Professional Secondary Claim (Continued)

Click Delete to remove the claim. To generate the secondary claim as institutional, go to Claim Activity. Enter the copied claim number in the Claim # box. Click View, then click the Claim # to open the Claim Details popup. Update the Claim Action/Status box to Send to Secondary.

3. Submitting the Institutional Claim to Secondary

Click Update Claims. On the Send to Secondary popup, uncheck Generate Professional Claim / CMS 1500. Then, click Send to Secondary. To submit the institutional claim to secondary, go to Billing, then Claim Processing. Update the search criteria by specifying the date range, record type as Pre Claims Check, claim type as Secondary Claims, billing entity, and facility. Click View. Finally, select the checkbox next to the Date of Service.

4. Submitting the Institutional Claim to Secondary (Continued)

Click Submit to finalize the process. This completes the conversion of a professional claim to an institutional claim within Billing Manager.