Custom Attachments Rules User Guide (Apex)

  Only users that have Claims or Admin permissions on the OneTouch site will be able to create or manage attachment rules. Apex currently offers Custom Attachments for Dental Claims only. 

Apex's Custom Attachment Rules feature (CAR) allows you to create rules based on payers and procedure codes so that when you submit a claim that meets the rule criteria, the claim will automatically be put into the Pending Attachment status.

Related Article: Dental Attachments User Guide

Jump to Section: [Access Custom Attachment Rules] [Create a New Rule] [Edit a Rule] [Delete a Rule]

Access Custom Attachment Rules

1. Log in to the Apex OneTouch website.
2. Click Manage Account in the upper right corner.
   
   
   
3. Click Attachment Rules.
   
   
   
4. Custom Attachment Rules display.
   

[Back to Top]

Create a New Rule

Create rules that will determine which of your claims will automatically pend for attachments in the New Rule section of Custom Attachment Rules. To create a rule you must specify a least one payer and one procedure code. You can also select multiple payers and procedure codes. 

1. Start typing the payer name in the bar below the Add Payer button. Select the name of the payer from the list that appears below. 
   

   NOTE: Only payers that support attachments will display in this list.

    
2. Click the Add Payer button to select additional payers to associate with the same procedure code(s). You can do this for as many payers as you need to. You can also use the All Payers checkbox to apply the rule to all payers. 
3. Start typing the procedure code in the bar below the Add Procedure button. Select the procedure code from the list that appears below. Click the Add Procedure button to select additional procedures, or click the All Procedure Codes checkbox to pend all the payer's claims for attachments. 
4. Click the - button next to a payer name or procedure code to remove it. 
5. Click the Submit button to save the rule to the Existing Rules section.
   

[Back to Top]

Edit a Rule

Edit procedure codes associated with a rule in the Existing Rules section of Custom Attachment Rules. You can not edit payers in an existing rule. If you want to change payers, you need to delete the existing rule and create a new rule with the appropriate payer. 

1. Click the Edit button in the Action column for the rule.
2. The New Rule section changes to an Edit Rule section and displays the procedure codes.
3. Click the Add Procedure button to add a new procedure code, or click the - button next to a procedure code to remove it. 
4. Click the Submit button to save your edits. 
   

[Back to Top]

Delete a Rule

Delete a rule in the Existing Rules section of Custom Attachment Rules.

1. Click the Delete button in the Action column for that rule.
2. To delete multiple rules at the same time, click the Checkboxes next to the payer rules, then click the Delete Selected button.
   

[Back to Top]