Claim Header

The Header contains general information about the encounter, such as the patient’s name, patient ID, DOB, medical record number, patient control number, details identifying the provider(s), payer, and other relevant demographic data included in the header section of HCFA, CDT, and UB claim forms. This section also includes diagnosis codes and, for facility encounters, the ICD-10-PCS codes, DRG, and other related data.

Auditee can follow the steps below to add Claim Header information in the Audit Worksheet:

• The first column lists the data elements assigned to the audit. The second column, Reported, displays the data to be audited. The third column, Audited, is where auditors can make corrections to the reported data, if needed.
• There are three methods to input the reported data in Audit Manager+. Usually, organizations automatically import this data into the encounter for the auditor. If the Reported column is blank, you'll need to manually enter the correct data for each element.

Note: If the imported data is incorrect, you can edit the values directly in the Reported column.

• Use the Audited column to correct any inaccurate data from the Reported column. You only need to enter values in the Audited column if the reported data is incorrect. If the reported data is accurate, leave the Audited column blank.
• To add the Result details, follow the Steps to add Additional Result Details. 
• Once all the Claim Header information are added, scroll down to the service line section and follow the instructions.

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