Is Patient’s Condition Related to…

What’s in the box?

This box indicates whether the patient’s illness or injury is related to their employment or an accident. For example, by checking the box labelled Employment (current or previous), the submitter indicates that the condition is related to the patient’s job or workplace.

Checking ‘Yes’ to one or more of these boxes tells the Insurer that the patient might have coverage (i.e. coverage from the employer) that should be treated as the primary.

Where does this info live in Jane?

When creating an Insurance Policy (Profile > Billing tab > Insurance Policies > View or New Insurance Policy), you are given the option to specify if the patient’s condition is related to Employment, Auto Accident, and/or Other Accident.

If one of the Accident boxes is checked, an Injury Date box 14 is also required in the Policy.

Note: if you check the Auto Accident box, the State (two-character abbreviation) in which the accident occurred is also required. i.e. CA for California.

Is this required?

Only check off one of these boxes if applicable to the patient’s condition or required by the Insurance company. It is optional and unchecked by default when creating a new Policy in Jane.

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What about the EDI file?

If one or more of the Accident Type boxes are checked, then the accident info (type, date, and/or state) will be included in Loop 2300 - Claim Info.

Specifically, the Accident Type(s) and state (if relevant) is included in Loop 2300, Segment CLM11. Note that element CML11 can have multiple parts depending on which accident(s) are reported.

The accident date is sent in the DTP segment of Loop 2300 (Box 14)

Patient Condition Related Causes Codes:

AA - Auto Accident

EM - Employment

OA - Other Accident