Submitting Claims Electronically

How to Submit Claims Electronically

When an encounter is posted, the system will create a claim and automatically mark it "Ready for Electronic Submission" if that insurance company has a payer ID. To submit claims electronically:

Step 1: Filter for claims with the status "Ready for Electronic Submission"

Step 2: Select one, a few, or all claims using the checkboxes in the first column

Step 3: Click the blue "Submit Claims" button found at the top of the list

Once Submit Claims has been pressed, all claim statuses are automatically changed to "Pending Insurance."

You can use the Claim Log within each claim to verify when it was submitted and when it was received by the clearinghouse and payer.

Addressing Errors

The system does some initial scrubbing of claims, so you may encounter errors when you try to submit claims. This is simply the system telling you that some pertinent information is missing or that something must be corrected before the claim is submitted.

For example, if you receive the error message "Billing Provider SSN is missing," it means the provider's Billing Configurations have been set up to transmit the provider SSN in field 25 of the CMS 1500 form instead of the Tax ID. To address this error, either the SSN should be added in the provider's account settings (if the SSN should be transmitted) or the Billing Configurations should be updated to transmit the Tax ID (if the SSN should not be transmitted).

Once the information is corrected, the claim should be validated (re-scrubbed) before trying to submit again.

Validating Claims

To validate claims, select the claims to be re-scrubbed and use the blue arrow in the bottom right-hand corner to access additional actions. Select Validate Claims to switch the action button. Now, click the blue Validate Claims button.