The Benefit Code (benefit code
Identifies the service type provided and determines the payment within the schedule. (codes differ per location)) is a key component in determining eligibility and pricing based on setup. If the BCode is missing, a pend P3 will be assigned to the line once you calculate (F7) or save the claim. Benefit codes are configured during the setup at your office.
Ctrl+D .If the BCode needs to be evaluated the entry box shows with an orange border. This message shows when you point to the field: Please enter a valid BCode. If there are valid selections, a green border displays around the box.
If one code is found during the Benefit Code search, it will automatically show in the field. If the BCode search finds multiple BCode selections, the BCode Lookup window displays so you can choose the correct option.
After you choose a BCode or change an existing one and tab into another field, the claim is re-evaluated and a check is performed to verify that the BCode is appropriate for the procedure (Benefit Code Referral Review). If not, a message will display (BCode criteria changed; please re-evaluate BCode.) and you might not be able to proceed with the claim until an appropriate BCode is selected.