Benefit Line Codes and Accumulators Screen





 

Button/Parameter Name

Function
Benefit Line Code Number Entering data here will modify an existing or newly created entry's Benefit Line Code Number in the table.
Benefit Line Code Type You may select one of the options to modify the existing or newly created entry. If nothing is specified in this field, an error is generated. When a claim is entered, the form type and employee option of the claim are used by the program to fill the Benefit Line Code boxes with exactly the codes that apply to that situation, i.e., MED codes for HCFA 1500 and UB forms, DEN codes for Dental claims, etc. ECO codes are used in the Explanation Code drop down lists.
Code Description Entering text here will modify the existing or newly created entry's Code Description. This is displayed in the Provider Explanation of Benefits statement, under the heading Services or Benefit Description. For Benefit Line Code Type ECO, if you include the word "Discount" in the Code Description, all claim lines that use that Explanation Code will calculate Employee Responsibility as the Allowed Amount instead of the Billed Amount.
EOB Description Entering text here will modify the existing or newly created entry's Explanation of Benefits Description. This is displayed in the Employee Explanation of Benefits statement, under the heading Services or Benefit Description.
BCode Group Association This will select which of the BCode Groups to associate the current or new entry with. This feature is used in the Benefit Code by Line Summary Report when the Collapse parameter is selected, and each benefit code will be grouped by Benefit Code Group.
New Creates a new entry in the Benefit Line Code table using the parameters to be specified by the user on the left side of the table.
Save Saves all new or modified entries in the Benefit Line Code table to the database.
Delete Deletes the selected entry in the Benefit Line Code table. This function automatically deletes the corresponding entry in the database, so clicking on save afterwards is not necessary.


 

Button/Parameter Name

Function
Category Number Entering data here will modify an existing or newly created entry's Category Number in the table.
Category Description Entering text here will modify the existing or newly created entry's Category Description. This will be displayed in the the Benefit Code by Line Summary Report as the group's description.
New Creates a new entry in the Benefit Line Code Groups table using the parameters to be specified by the user on the left side of the table.
Save Saves all new or modified entries in the Benefit Line Code Groups table to the database.
Delete Deletes the selected entry in the Benefit Line Code Groups table. This function automatically deletes the corresponding entry in the database, so clicking on save afterwards is not necessary.


 

Button/Parameter Name

Function
Accumulator ID Entering data here will modify an existing or newly created entry's Accumulator ID in the table.
Accumulator Description Entering text here will modify the existing or newly created entry's Accumulator Description.
New Creates a new entry in the Plan Accumulators table using the parameters to be specified by the user on the left side of the table.
Save Saves all new or modified entries in the Plan Accumulators table to the database.
Delete Deletes the selected entry in the Plan Accumulators table. This function automatically deletes the corresponding entry in the database, so clicking on save afterwards is not necessary.


  The Done button closes the Benefit Line Code Screen, returning you to the Admin Report Screen. This will also lose all unsaved modifications to the three tables.