Prompt | Response | Req | Len |
---|---|---|---|
From Electronic Form | Select the electronic form number you want to start with or leave the field blank to begin with the first code. | 2 | |
Through Electronic Form | Select the electronic form number you want to end with or leave the field blank to end with the last code. | 2 | |
Begin with Date | Type the date you want to begin with or click the calendar icon to select a date. This date refers to the date the insurance claim file was created.This date refers to the date the insurance claim file was created. | 10 | |
End with Date | Type the date you want to end with or click the calendar icon to select a date. This date refers to the date the insurance claim file was created. | 10 | |
Alpha or Numeric | Select the option to print the patients in alphabetical order by last name or in numeric order by account number. | 1 | |
Page Between Carrier | If you want each carrier to begin printing on a new page, select this check box. | 1 | |
Print Patient Total | If you want to print a total claim dollar amount for each patient, select this check box. | 1 |