Claim Inquiry form for Medi-Cal (State of CA Medicaid). Separate area (similar to Batch Payment Posting) for sending Claim Inquiry (overpayment, under payment, etc.) to an insurance company. This should generate on the Medi-Cal form template from Medi-Cal or any Mail Merge document created by the practice.

Requested Steps to define spec:

1. Billing menu
2. Claim Inquiry Module (to send a Claim Inquiry letter for any claims)
4. Select Patient(s) and Sequence(s) to send Claim Inquiry (up to 4 patients) (similar to Batch Payment Posting)
5. Select (5) Claim Type (01 Pharmacy, 02 LTC, 03 Hospital Inpatient, 04 Hospital Outpatient/Clinic, 05 Physician/Allied, 07 Vision)
6. Select (6) Delete (if needed)
7. Enter (9) Claim Control No. for each Date of service
7. Select type of Inquiry (10) Attachment (11) Underpayment (12) Overpayment
8. Enter (14) NDC/UPIN or Procedure Code
9. Select (15) Enter Amount Billed
10. Enter REMARKS relating to claim

Expected Result:
Box (3) Provider Name/Address, (4) Provider No. (Provider/Practice Ins No.), (7) Patient Name, (8) Patient’s Medi-Cal No. (Policy #) (13) Date of Service, to auto-populate based on Plan Set from sequence
Boxes (5), (6), (9), (14), (15), REMARK, to allow user to manually enter data.
All data entered should print on the Claim Inquiry form provided by Medi-Cal in the correct fields. For other insurance plans, user can select the mail merge document created by practice.
Current Result:

N/A

Impact on Workflow:

High, this can speed up the Claims Inquiry request process for the client. They will not have to type information individually onto each form by hand writing information.