How to Copy a Claim Exception

You can either copy a claim exception code to another line of business or replicate the code as a base for a new code within the same line of business.

You use the Copy to LOB function to copy claim exception code information from one line of business (LOB) to another. All the existing claim exception code LOB-specific information is used to create a new copy of the claim exception. You can use this function to add a new LOB to an existing claim exception or to copy an existing exception to create a new one.

You use the Replicate Claim Exception function to copy the claim exception code information within the same line of business. All the existing claim exception code LOB-specific information is used to create a new claim exception code that can be edited for the differences. You use this function to add a new code that is similar to an existing claim exception code in that LOB.

Optionally, you can:

• View or add notes. To view or add notes for this record, on the action bar, click Notes.

To copy or replicate a claim exception

1. On the Rules Mgmt menu, click Claim Exception.
2. Search for the claim exception code you want to copy.
3. To copy or replicate, on the Claim Exception page, select the claim exception that you want to copy.

4. On the Claim Exception action bar, do one of the following:

   • To copy the code to the same LOB as a base for a new code, click Replicate Claim Exception.

   • To copy the code to another LOB, click Copy to LOB.

   The copied claim exception record is available to edit.

5. In the header panel, edit all applicable information.

6. Edit detail information using the following tabs:

   • Main (default overrides)
   • Disposition (for medical claim exception or for pharmacy claim exception)
   • Resolution
   • Response

   Note: Resolution and Response data apply to all lines of business (LOBs), so if you update these when copying or replicating an exception code, you are updating them for all LOBs.

7. On the Claim Exception action bar, click Save.

Note: A warning message is displayed when a change is made to header information. You are asked to verify the change you made.

See Also

Claim Exception (Main Tab) Page

Claim Exception (Disposition Tab) Page

Claim Exception (Resolution Tab) Page

Claim Exception (Response Tab) Page

What Is Claim Exception?

About Rules Management

Version as of 5/16/14.