We are currently updating the OP Help Center content for the release of OP 14.19 or "OP 19". OP 19 is a member of the certified OP 14 family of products (official version is 14.19.1), which you may see in your software (such as in Help > About) and in the Help Center tabs labeled 14.19. You may also notice that the version number in content and videos may not match the version of your software, and some procedural content may not match the workflow in your software. We appreciate your patience and understanding as we make these enhancements.

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 will be sent to your clearinghouse.

Create and Send Electronic Claim Files

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

  1. click Yes when prompted Transmit unsent claim files to payers?. 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.

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.

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.