RBS Dynamic Validation
Rule-Based System
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Enter claim information to validate against active rules
Claim Information
Claim ID
*
Date of Service
*
Claim Filing Indicator
Principal Diagnosis (ICD Codes)
ICD 1
ICD 2
ICD 3
ICD 4
ICD 5
ICD 6
ICD 7
ICD 8
ICD 9
ICD 10
ICD 11
ICD 12
Patient Information
First Name
Last Name
Date of Birth
Gender
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Procedures
Procedure 1
CPT Code
*
Units
Modifier
Place of Service
NDC
Service Date
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