I am having trouble creating a custom claim edit rule that works. Basically for one payer I want to make sure that the modifier 1 field of the charges is not empty.
At first I tried to set it up where the Payer ID matched the Payer ID in Medisoft and I indicated also a condition if the Modifier 1 field was blank to return an error. That did not work. So I tried using the Insurance Carrier 1 for the claim and that also did not work (see screenshot of the rule).
I DID tie the rule to the payer and saved it, but when I ran the rule it passed...even though I tested by not having a modifier in the modifier 1 field for one of the charges on the claim.
ClaimEditRule.png [ 158.96 KiB | Viewed 255 times ]
Medical Billing Professionals