Create and Send Electronic Claim Files

Version 14.8

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.

Create and Send Electronic Claim Files

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

  1. When prompted Claim files have been created. Transmit now, click Yes. OP will transmit to clearinghouse and go 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 will be able to provide details as to when the file was received by their system.