This guide provides a step-by-step overview of how to create a Personal Injury/Settlement case and set up the corresponding policy information in ChiroHD.
Step 1: Create the Personal Injury Case
Access the Patient Profile:
Search for the patient using the search bar.
OR click on their name on the calendar.
Click on the Cases tab, and click Create New Case.
Choose from the dropdown menu, Personal Injury/Settlement Case Type.
Most often, you will select Billing Suspended for PI cases
Reason: Attorneys and insurance companies typically prefer to receive bills and statements at the conclusion of the case, not weekly.
Click Save Changes.
Set the newly created Personal Injury/Settlement Case as the patient's default case by clicking the push pin icon (Optional).
Step 2: Add Diagnosis Codes (DX Codes)
Open the PI Case Case < Treatment / DX Tab.
Add Diagnosis Codes by clicking in the Add code to case.
Choose the Start Date (It will default to today’s date).
Save Changes.
Tip: If you backdate the first DX code, subsequent codes will use the same start date automatically.
Step 3: Add Insurance Policy Information
Go to the Insurance/Coverage Tab, Click Add New Insurance/Coverage.
Fill Out the Insurance/Coverage fields.
Insurance Company/Attorney and Nickname: Select the appropriate third-party payer (must be pre-created).
Priority: Choose primary or secondary coverage. If there is only one coverage entity, then select Primary.
Coverage Start Date and End Date: Set based on the duration of the case. The end date can be left blank if unknown.
ID/Claim Number: Enter the claim number provided by the insurance or attorney.
Group Identifier: N/A
Plan Identifier or Prior Authorization Number: Optional.
Notes: Optional, for any internal notes.
Relationship to Insured: Insured is self if billing Med-Pay. Insured is someone else if billing at-fault, to an attorney, or if a passenger or child in insured vehicle.
Claims Related To: Choose Auto Accident
State of Incident (if applicable): Indicate the state where the accident occurred.
Maximum Coverage (MedPay, if applicable): Enter the maximum available coverage amount.
Date of Current Illness or Injury: Enter the accident date.
Onset Qualifier: Select Accident
Additional Details:
Box 19 and Referring Provider are optional based on case needs.
Billing Provider Other ID: Box 33b (optional)
Accept Assignment will default to "Yes" but this is where the office would say whether they are accepting assignment from the third party payer or not.
Check for Missing Patient Information:
A red warning will appear if key patient information (e.g., gender, birthdate) is missing.
Click Edit next to the patient's information and complete the missing fields.
Click Save.
Step 4: Set Up Default Services (Optional)
Under Default Services tab, select services that will automatically populate on each SOAP note for this case.
Click Save Changes.
For detailed instructions and step-by-step guidance (video included), please refer to our resources on Setting Up Default Services.
Step 5: Additional Tabs in Patient Cases
Transactions Tab:
View the transactions specific to this insurance case.
Settings Tab
Edit Case Name. Adjust the Case Name if desired (e.g., "PI - John Doe - 2024").
Suspend Billing: Used primarily for PI (Personal Injury) cases where billing should be delayed until settlement.
NOTE: If billing is suspended, services tied to the PI case will NOT appear on the Create a Claim screen.Change Case Type.
Set Default Calendar Provider and Default Billing Provider for this case.
Helpful Reporting Tip
Tracking Billing-Suspended Items Report:
Go to Reporting > Simple Reporting > Health Check > Billable Items on Suspended Cases. This report shows all services attached to suspended cases to ensure nothing is missed when billing is resumed.
Key Takeaways
Billing Suspended is typically standard for PI cases unless specifically directed otherwise by the attorney or insurance company.
Always ensure the attorney or insurance company information is entered correctly as a third-party payer before creating the case.
Completing fields like Claim Number, State of Incident, and Maximum Coverage ensures smoother final settlement processes.