5010 Electronic Claim Loop and Segment Editor

With the 5010 Electronic Claim Loop and Segment Editor, you can set up special requirements for your claim files that may deviate from the standard requirements. For example, practices submitting claims directly will likely have at least one custom profile defined, because the header loop will contain different information than what would be sent, by default, to EMEDIX. 

You may set up as many profiles as are necessary for your particular circumstances and use them in as many rules are as necessary. A profile must be attached to a rule for it to be in effect.

The Editor includes two tabs:

• The Loop and Segment Profile Rules tab is a tree view of the rules that have been defined. When you first open the Editor, before any custom profile rules have been defined for your practice, you will notice one Default Profile. Once you start creating more profile rules, they will appear in the tree.
• The All Profiles tab is a list of all of the profiles that have been created with an indication of whether they are used in a rule or not. A profile must be associated with a rule to be in effect.

Action Column options:

• Click History to view a history of changes to rules. The current version—that is, what you saw in the Loop and Segment Profile Rules tree, before clicking History—, is indicated by the word “Visible.” To view a different version of the rules in effect, click the View link.
• Click New L/S Profile to create a new profile.