Timely Filing Payer Rules

Timely Filing Payer Rules allow for claim provisioning to predefined groups and/or users when a claim enters a specific threshold. This screen is accessed by clicking the Define Rules button in the Define Thresholds screen, or from the Define Rules option in the Admin menu (Admin > XClaim > Timely Filing).

This is the third and final step in configuring the Timely Filing feature. This screen displays a summary of timely filing rule attributes:

Rule Name: Unique name that identifies the Payer Rule.
Threshold Days: Number of calendar days from the Payer's Timely Filing deadline that the claim will be identified with the Threshold Color, as defined in the Define Thresholds screen.
Threshold Color: Color that will appear in the claim's Days to TFD column in the claims grid, as defined in the Define Thresholds screen.
Assigned Group: Indicates the group to which the claim is assigned when it is within the defined threshold.
Assigned User: Indicates the user to which the claim is assigned when it is within the defined threshold.
System Alert: Indicates whether the owner of the claim receives a System Alert when the claim enters the defined threshold.

Users may add, edit, or delete rules using the buttons at the bottom of the screen, or from the context (right-click) menu in the grid. You can create as many Payer Rules as necessary to ensure that the appropriate user/groups are notified to take action on claims prior to the timely filing deadline. Selecting New or Edit opens the Apply Rule to Payer(s) screen in a new window. Complete the required fields and click Save to commit changes, and then Close to return to the Timely Filing Payer Rules screen.