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Inhibit Retro Claim Adjudication Section

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Define rules for when and where voids and adjustments are allowed to be entered for selected providers or classification of providers.

Menu path

Avatar MSO > System Maintenance > Claim Processing Automation

Steps 

  1. In the Define Retro Claim Adjudication Inhibit Rule by Provider field, select whether to define the inhibit rule by Classification, Provider, or All.
  2. In the Provider/Classification field, choose the classifications or providers to trigger the inhibition.
  3. In the Retro Claim Origin field, check each of the claim sources that should trigger the inhibition.
  4. In the Retro Claim Adjudication Inhibit Rule field, check the box to have the system check that the Service has not been included on an 835 File.
  5. Click File to save the rule.
    OR
    Click Delete to remove the rule.