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We are currently updating the OP Help Center content for the release of OP 20. OP 20 (official version 20.0.x) is the certified, 2015 Edition, version of the Office Practicum software. This is displayed in your software (Help tab > About) and in the Help Center tab labeled Version 20.0. We appreciate your patience as we continue to update all of our content.

Create and Send Electronic Claim Files

Version 14.19
Path: Billing tab > Billing Center button > Queue tab

Overview

When creating and sending electronic claim files, all queued claims assigned to insurance payers setup for electronic claim submission are sent to your clearinghouse.

Create and Send Electronic Claim Files

  1. Click the Billing tab and click the Billing Center button.
  2. Click the Queue tab.
  3. Click the Create Files button.
  4. Click the Yes button when prompted Create claim files for transmission to payers?  

  1. Click the Yes button when prompted Transmit unsent claim files to payers?. OP transmits to the clearinghouse and goes idle when complete.



Claims remaining in Transmit Queue after file transmission are:
  • Self-Pay claims
  • Claims for insurance payers who have a claim transmission type of Standard HCFA in the Claims/Routing tab of the payer's setup.
  • Problem claims

Visit Your Clearinghouse Regularly

It is recommended after sending claim files that you follow up by logging into your Clearinghouse and confirming the receipt of the the claim file(s). Clearinghouses typically advise that you wait 24 hours prior to checking for your claim files, but some may be there sooner and it does vary by clearinghouse. Concerns regarding the amount of time it takes for your clearinghouse to receive files should be directed to your clearinghouse. They will be able to provide details as to when the file was received by their system.

Version 14.10

Overview

When creating and sending electronic claim files, all queued claims assigned to insurance payers setup for electronic claim submission will be sent to your clearinghouse.

Creating and Sending Electronic Claim Files

  1. Click the  Billing buttonto open the e-Billing center.
  2. Click the Transmit Queue tab.
     
  3. Click the Create Files button ,then click the Yes button when prompted Create claim files for transmission to payers?  

  1. When prompted Claim files have been created. Transmit now, click the  Yes button. OP transmits to the clearinghouse and goes idle when complete.


Claims remaining in queue after file transmission are:
  • Primary claims waiting to be printed on a CMS-1500 form.
  • Secondary claims waiting to be printed on a CMS-1500 form.
  • Problem claims - view these claims in the Claims+A/R tab to determine and correct the problem.

Visit Your Clearinghouse Regularly

It is recommended after sending claim files that you follow up by logging into your Clearinghouse and confirming the receipt of the the claim file(s). Clearinghouses typically advise that you wait 24 hours prior to checking for your claim files, but some may be there sooner and it does vary by clearinghouse. Concerns regarding the amount of time it takes for your clearinghouse to receive files should be directed to your clearinghouse. They are able to provide details as to when the file was received by their system.