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Claims Generation Requirements

The following information and data points are required to generate claims within Curitics

Submitter Information

Data ElementExample Value
Submitter Tax ID/EIN970914123
Organization NameCuritics Client

Billing Provider

Data ElementExample Value
Billing Provider Tax ID (if different from submitter)970914123
Organization Name (if different from submitter)Curitics Client
Address (address 1 & 2)123 Central Ave
CitySt. Petersburg
StateFlorida
Postal Code34221

Clearinghouse (General)

Data ElementExample Value
Receiver Tax ID330897513
Organization Name Office Ally

Payor/Client Configuration

The below data elements are required for each unique client in the system.

Data ElementExample Value
Payer ID (from Clearinghouse)12345
Payer NameExample Health Plan
Claims Address (address 1 & 2)456 Payer Ave
CityBeverly Hills
StateCalifornia
Postal Code90210

Chargemaster Configuration

The below data elements are required for each CPT/CPT2 code to be billed using the claims generation workflow.

ClientCPT/CPT2Charge (in $)Place of Service Code
Example Health PlanG043827502