View and Edit Claim Details as a Claims Administrator
1. Go to the Claim Management Page
2. Edit Patient Information
You will be brought to the Manage Users page to edit the patient's information if edits need to be made
- Edit information by clicking on Patient Dashboard or Edit
- Message the Employer if you need clarification for any information
3. View the Injury Details
This information is set in the encounter room with a coordinator or provider
3.1. Set the Claim Type
Selecting a Claim Type will allow you to set the claim status. Once an option is selected in this field, it will be automatically saved
3.2. Update the Claim Status
- If the claim status was set by the Provider or Coordinator in the portal, it will show in this field
- The SAVE button only saves changes made to the Claim Status, not the other fields on the page
- There is no order in which the status of a claim is set; you can go from, 5020 to PR-4 and vise versa if necessary
3.3. Choose the Assigned Claim Admin
Depending on the client, The Claim Admin selected may only be able to see and manage this claim
3.4. Choose the Assigned Attorney
Depending on the client, The attorney selected may only be able to see and manage this claim
4. Update the Claim Information
If the Provider or Coordinator entered Workers' Comp data in the encounter, you will see what was entered here
- The SAVE button will only save the data that is in the current tab
- Click on the Back to Claims Search link to go back to the claims search page
5. Update the Employer Information
- If the Provider or Coordinator entered Workers Comp data in the encounter, you will see what was entered here
- The SAVE button will only save the data that is in the current tab
6. Update Injury Information
- If the Provider or Coordinator entered Workers Comp data in the encounter, you will see what was entered here
- The SAVE button will only save the data that is in the current tab
7. View Encounter Worker's Comp Details
- The information displayed here will show you the Worker's Compensation Data that is specific to the encounter selected
- The encounters that can be seen here will be encounters related to the claim you are viewing
8. View Treatment Plans
9. View Encounters Related to the Claim
- Under the Files section, you will see Workers' Comp files and Encounter Notes uploaded for each encounter.
- Here you will see all of the encounters that are associated with the claim
- You may message the coordinator or provider in this tab
10. Claim Uploads
- If any uploads were made during the encounter, you will find them here
- You may add a new file if you have one available by clicking on New File
11. Treatment Authorizations
Any treatment authorizations will be listed here if available
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