Claritiv
Dashboard
New Audit
New Claim Audit
Submit a medical claim for automated coding review and compliance analysis.
Load sample claim (demo with intentional errors)
Patient Information
Optional
Patient Name
Date of Birth
Gender
-- Select --
Male
Female
Other
Patient ID
Provider & Claim Details
Provider Name
Provider NPI
*
Date of Service
*
Place of Service
-- Select --
11 - Office
12 - Home
19 - Off Campus Outpatient Hospital
20 - Urgent Care Facility
21 - Inpatient Hospital
22 - On Campus Outpatient Hospital
23 - Emergency Room - Hospital
24 - Ambulatory Surgical Center
25 - Birthing Center
31 - Skilled Nursing Facility
32 - Nursing Facility
41 - Ambulance - Land
42 - Ambulance - Air or Water
49 - Independent Clinic
50 - Federally Qualified Health Center
51 - Inpatient Psychiatric Facility
53 - Community Mental Health Center
61 - Comprehensive Inpatient Rehab
65 - End-Stage Renal Disease Facility
71 - Public Health Clinic
72 - Rural Health Clinic
81 - Independent Laboratory
99 - Other Place of Service
Payer Name
Claim Number
(auto-generated if empty)
Diagnosis Codes
1
Add Diagnosis
Procedure Lines
1
Add Procedure Line
Submit & Save Audit
Preview Audit