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.

Update Claim Status with Clearinghouse Acknowledgements

Version 14.19

Overview

Claim Acknowledgments and Rejections can be displayed in OP if your office has a supported clearinghouse. Claim Acknowledgment reports are processed into OP via a workflow known as Fetch and Process.

  1. Navigate to the Billing Center: Billing tab > Billing Center button
  2. Click the Claims (A/R) tab.  
  3. Click the Fetch Files button, then click Yes when prompted Fetch Payer Reports?.


This action will fetch (retrieve) any unread acknowledgment reports from your clearinghouse and place them in the Administrative Documents Repository.

  1. Click the Process button. This action will allow OP to read any unread acknowledgment reports from your clearinghouse and updated the corresponding claim category codes.
  2. Click Yes when prompted Process Payer Reports?
  3. You will now be able to view the most recent claim status from your clearinghouse.

You also have the option to manually add a claim status by doing the following:
  1. Select the claim in question.
  2. Select the Status history radio button.
  3. Click on Add Status button. A blank entry line displays.
  4. Use the Status Category dropdown to select an updated or alternate status.
  5. Edit the Note field if/as applicable to provide further details of this status change.
  6. Click the Save button to save this status update.
Version 14.10

Overview

If your office has a supported clearinghouse and your claim audit reports are automated through your clearinghouse.

Update Claim Status

  1. Click on the Billing button to open the e-Billing center.
  2. Click on the Claims + A/R tab .  
  3. Click on the Fetch button, then click Yes when prompted Fetch Payer Reports?. OP will go idle when the process is complete.

This action will fetch (retrieve) any unread audit reports from your clearinghouse and place them in your Administrative Documents.

  1. Click on the Process button . This action will allow OP to read any unread audit reports from your clearinghouse and updated the corresponding claim status.
  2. Click Yes when prompted Process Payer Reports?. OP will go idle when the process is complete.
  3. You will now be able to view the most recent audit report response of claim status from your clearinghouse.

You also have the option to manually add known claim status as follows:
  • Click on the claim in question (it will appear highlighted)
  • Click on the radial dial for Status history .
  • Click on Add Status Icon.
  • Click on the Pencil icon to allow edits.
  • Click on the dropdown in the status category field (below the specified claim) to select an updated or alternate status.
  • Edit the Note field if/as applicable (to provide further details of this status change).
  • Click on the green checkmark to save this status update.