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)
Click into the PI Case.
Navigate to Treatment/DX.
Add Diagnosis Codes by clicking in the Add code to case.
Search for the diagnosis name or code.
Select the appropriate DX Code.
The start date will default to today’s date; adjust it if necessary.
Tip: If you backdate the first DX code, subsequent codes will use the same start date automatically.
4. Save Changes.
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: Start typing the first three letters of the Payer Name for the dropdown payer list to populate.
Priority: Choose primary or secondary coverage.
Coverage Start Date and End Date: Set based on insurance verification.
ID/Claim Number: Enter patient id as shown on the patient's insurance card or claim number.
Group Identifier: Enter if available from the insurance card.
Plan Identifier or Prior Authorization Number: Optional.
Notes: Optional, for any internal notes.
Relationship to Insured:
If the patient is the subscriber, select Self.
If insured under a spouse or parent, select the relationship and enter the subscriber’s information.
Claims Related To: Choose one of the following (None, Auto Accident, Other Accident, Work)
State of Incident (Optional): Indicate the state where the accident occurred.
Maximum Coverage (MedPay, if applicable): Enter the maximum available coverage amount.
Date of Current Injury: Enter the accident or illness date.
Onset Qualifier: Select Accident or Onset of Current Illness.
Additional Details:
Box 19 and Referring Provider are optional based on case needs.
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 Knowledge Base Article on "Default Services" here.
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.
Important Notes
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.
By following these steps, you can confidently set up personal injury cases and avoid common billing mistakes that delay settlements.