ClaimRev Support Documentation

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====== Manual Claim Entry ======

> **Beta feature.** Manual Claim Entry is currently in beta and may not be enabled for your account yet. If you don't see it in your menu and would like access, contact ClaimRev support.

This guide explains how to hand-key a paper claim — a **CMS-1500** (professional) or a **UB-04** (institutional) — directly in the ClaimRev Portal, validate it, and submit it for processing. It's intended for billers who need to enter a claim by hand rather than uploading an 837 file.

> If you already have an EDI claim file, you don't need this screen — see **[[guides:uploading-claim-files|How to Upload Claim Files]]** instead.

===== Step 1: Open Manual Claim Entry =====

From the left-hand navigation menu, click **Claims** to expand the submenu, then click **Manual Claim Entry**.

You'll land on the Manual Claim Entry list. From here you can:

  * Search and filter your existing drafts (by patient, charge, status, and created date)
  * Start a new claim
  * Select drafts and submit them as a batch

===== Step 2: Start a New Claim =====

Choose the form that matches your paper claim:

  * **New CMS-1500** — for professional claims (837P)
  * **New UB-04** — for institutional claims (837I)

The entry screen is laid out to mirror the paper form, so you can key boxes in the same order they appear on the page in front of you.

===== Step 3: Key the Claim =====

Fill in the fields just as they read on the paper form. A few helpers make this faster:

  * **Look up payer** — instead of typing the payer name and number by hand, click **Look up payer**, search for the payer, and select it. The payer name and number fill in automatically. //(A payer number is required before a claim can be submitted — see Step 6.)//
  * **Dropdowns for coded boxes** — boxes that take a specific code (for example, CMS-1500 Box 27 *Accept Assignment* and Box 31 *Signature*) are dropdowns so you don't have to remember the valid values.
  * **Service lines** — service lines are entered in a table. Click a line (or **Add Line**) to open the line editor, where you enter the procedure/revenue code, charge, units, and link diagnosis pointers using the diagnosis chips.

> **Outside lab (CMS-1500 Box 20):** if you mark Box 20 and enter a charge, also enter the **outside lab's name, NPI, and address in Box 32 (Service facility)**. The outside lab //is// the service facility on the EDI claim, so its NPI is what carries the purchased-service charge. A claim with an outside-lab charge but no Box 32 service facility can't be submitted (see Step 6).

===== Step 4: Validate =====

Click **Validate** at any time to check the claim. If everything required is present, you'll see a green confirmation panel. If something is missing or inconsistent, the issues are listed in a panel so you can fix them before submitting.

> **Good to know:** Validate checks the claim's data (required fields, payer number, and so on). Some deeper structural checks happen later, during processing — so it's still a good idea to watch the claim's status after you submit. See **Known Limitations** below.

==== Attaching the source document (optional) ====

If you're working from a scanned image or PDF of the paper claim, you can attach it to the draft for reference:

  * Use the **upload** control to attach the image or PDF
  * The attached document can be viewed alongside the form while you key
  * You can remove it again with the **delete** option

===== Step 5: Save =====

Click **Save** to store the claim as a draft. Saved drafts appear on the Manual Claim Entry list, where the **Patient** and **Charge** columns are filled in from what you keyed. You can return to a draft later to keep working on it.

===== Step 6: Submit a Batch =====

When one or more drafts are ready:

  - Return to the **Manual Claim Entry** list
  - Select the draft(s) you want to send using the checkboxes
  - Click **Submit Batch**

The selected claims are converted to the correct format (837P for CMS-1500, 837I for UB-04) and sent for processing.

> **Some checks block a batch.** A claim is held back (and called out) if:
>   * it has **no payer number** — use **Look up payer** to set it; or
>   * **Box 20 (outside lab)** has a charge but **Box 32 (service facility)** has no NPI — add the outside lab's details in Box 32.
> Fix the flagged claim and submit again.

===== The Advanced Editor =====

Some claims need details the paper form doesn't capture. From a draft, you can open the **Advanced editor** to work on the claim in ClaimRev's full claim editor, which exposes the complete set of claim fields.

> **Important — this is a one-way step.** Once you open a draft in the Advanced editor, the paper-form view for that draft becomes **read-only**. From then on you edit and submit the claim from the Advanced editor. Only move a claim to the Advanced editor when you genuinely need a field the paper form doesn't offer.

===== Known Limitations (Beta) =====

Please keep the following in mind while the feature is in beta:

  * **Secondary / coordination-of-benefits (COB) claims are not supported here.** Key the primary claim, then use the full claim editor to complete a secondary claim.
  * **A few rarely-used fields aren't on the form** — e.g. other provider (UB-04 FL79), responsible party (FL38), employer name (FL65). If you need one, use the **Advanced editor**.
  * **Two-layer validation.** The in-form **Validate** confirms your data is complete; some structural checks run later during processing, so a claim that validates can still need attention after submission. Watch the claim's status.

===== Reporting Problems =====

When contacting support about a manual claim, it helps to include:

  * The claim type (CMS-1500 or UB-04)
  * The patient and payer
  * Where it failed — Validate, Submit Batch, or after submission (processing status)

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//See also: [[guides:uploading-claim-files|How to Upload Claim Files]] · [[guides:claim-search|Claim Search]]//

//Need help? Contact ClaimRev support at [[mailto:help@claimrev.com|help&#64;claimrev.com]] or call 918-842-9564.//