Enter Claims

There are several ways to enter claims into the Care Management system:

• The MCO Organization enters claims manually.
• The provider enters claims manually.
• Claims are submitted electronically from the provider using the electronic 837 format.

The MCO Organization Enters Claims Manually

1. If you are an MCO organization who enters the claims manually, use the Institutional  and Professional icons on the task bar of the Claim Lines (###) list page.

Notice the red rectangle around the icons in the task bar in the screen image below.

2. Use the Institutional icon to enter claims for an institution such as a hospital or inpatient care facility. Tell me how...

3. Use the Professional icon to enter claims for a licensed individual such as a psychiatrist or clinician. Tell me how...

A Provider Who Enters Claims Manually

1. If you are provider organization who enters claims manually, use the Provider Institutional  and Provider Professional icons on the task bar of the Claim Lines (###) list page.

Notice the red rectangle around the icons in the task bar in the screen image below.

2. Use the Provider Institutional icon to enter claims for an institution such as a hospital or inpatient care facility. Tell me how...

3. Use the Provider Professional icon to enter claims for a licensed individual such as a psychiatrist or clinician. Tell me how...