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Claims privileges

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Path: Administration>Configuration>Operators>Privileges [Scope Name]

The Claims component is divided into the following groups for which you can set up privileges:

Claims – Process

The following privileges appear in the Claims>Process group on the Privileges [Scope Name] tab for operators, roles and groups.

Policy Name Access Details

Process a Cycle

Provides full or read access to the Process a Cycle window.

Define Immediate Cycle

 

Provides full or read access to the Define Immediate Cycle window.

Annotate Claims

Provides full or read access to the Annotate Claims window.

Field Status Review

Provides full access to the Field Status Review window.

Close AR

Provides full access to the Close AR window.

Late EMC

Provides full or read access to the Late EMC window.

Accumulated NOE's

Provides full access to the Accumulated NOE's window.

Reprint NOE's

Provides full access to the Reprint NOE's window.

Treatment Authorization

Provides full access to the Treatment Authorization window.

Schedule Billing Cycles

 

Provides full access to the Schedule Billing Cycles window.

Can Schedule Billing Cycles for All Business Units

Provides full access to scheduling billing cycles for all Business Units in the Schedule Billing Cycles window.

Can Unschedule Billing Cycles

Provides full access to unscheduling billing cycles in the Schedule Billing Cycles window.

Can Run Billing Cycles Batch Processing

Provides full access to running billing cycles for batch processing in the Schedule Billing Cycles window.
Claims – Reports

This section contains a list of privileges for the reports available from the Claims>Reports menu. All these reports have only the Full Access type of security, so you may either allow or deny operator to access them.

Following is the list of the reports (corresponding to the policy names) you can grant privileges for:

  • Authorization Report
  • Continuous Care
  • Consolidated Billing Report
  • Patient Statements
  • Patient Supplies Claim Supplement
  • Physician Charges
  • Voids/Replacements
  • Claim Alerts
  • Billing Cycles Batch Processing Report
Claims – Management

The following privileges appear in the Claims>Management group on the Privileges [Scope Name] tab for operators, roles and groups.

Policy Name Access Details
Claim Resubmission Provides full access to searching for and resubmitting closed claims in the Claim Resubmission window.
Claim Suspension Provides full access to searching for and resubmitting closed claims in the Claim Suspension window.