Category: Submit Claims

Claim Generation and Submission Automation The system now supports automatic generation and submission of claims. A new option, Auto Claim Generation and Submission, has been introduced on the Billing Options page, replacing the previous Claim Creation Frequency field. Users can configure their preferences to enable or disable automation. Additionally, they can specify whether claims should […]

Claims with Attachments Many electronic payers can receive and use supplemental information through the  Paperwork (PWK) segment, as defined in the Health Care Claim 837 Implementation Guide. This segment contains paperwork codes to indicate documents available to the payer if needed. About PWK The PWK segment provides the ‘linkage’ between electronic claims and additional documentation […]

  Table 1 explains each of the boxes in the HCFA Form Field # Field Name Field Description/Instructions 1 Coverage PAYER TYPE of the destination payer. The type of health insurance coverage applicable to this claim by checking the appropriate box. 1.a Insured’s ID Number List the Insured’s identification number entered in the subscriber# field […]

Claims Dashboard The Claims Dashboard provides detailed information on every claim generated in the system. The dashboard has a pie chart representation to get a quick view of the number of claims in the different statuses. Image 1 is a sample screenshot of the dashboard. Note: Info icon (arrow-marked in the above image) will display […]

Claim Details on the Print/Rebill Screen The Print/Rebill screen can be used to view the current line status of a claim and any previous claim or line activity. To view the claim details, follow the steps below. 1. From the Print/Re-Bill screen, pull up the claims using the search options available. In Image 1, claims […]

Claim History Claim history gives a view of all submitted claims. Claims are sorted in reverse chronological order, with the most recent claim date appearing first. Search Filters of Claims History Image 1 Search Filters  Claim Date, Insurance, Claim #, DOS, Patient, Claims Receiver, Insurance Level, Legal Entity, Provider, Payer Claim #, Claim Batch Type, […]

Claims can be filtered and viewed according to their insurance levels, such as primary, secondary, and tertiary. The Print/Rebill tab of the Submit Claims screen provides the facility to filter claims according to the insurance level. Follow the steps below to list claims by insurance level. 1. Select Charges from the main menu and click […]

Multiple claims can be rebilled and batched on a single screen. This facility is provided by the Print/Rebill screen. To rebill and batch multiple claims, follow the steps given below. 1. Select Charges from the main menu and click on Submit Claims. 2. Select the Print/Re-Bill tab (see Image 1). Image 2 Enter the parameters […]

Submitted electronic claims can be printed onto paper. Follow the steps below for printing electronic claims. 1. Choose the Submit Claims menu under Charges from the left main menu. 2. Select the Print/Re-Bill tab (see Image 1). Image 1 3. To pull up the electronic claims, select the Batch Type as EDI and Claims Status […]

New Paper Claims New paper claims are the paper claims for which claim numbers are generated and are ready to be submitted but not yet sent to the payer. Once printed, they are assumed to be sent. Hence, paper claims in the system are either in New or in Printed state. To view all the […]