Claims |
The Claims list page shows all claims created in the program. This is the area where claims are created, corrected, and sent.
Click the Claims option in the toolbar.
To process a claim, double-click it to view the details. By default the ADA 2003 form is used. If you want to change the form, click the down arrow below the Claim Information tab and choose a different format.
Look over the claim and fill in any missing critical information.
Open the Billing and Claim Information tabs to assist in making corrections also. If you want to send the claim electronically (and have not set that designation in the Insurance screen), open the Billing tab and click Electronic at the bottom of the Primary Insurance area.
Correct claim information, such as place of treatment, information concerning orthodontics and prostheses, information concerning accident-related injuries, and enclosures in the Claim Information tab.
After making any corrections, click Save Changes.
Sending Electronic Claims
Choose the claim(s) and click Send Selected E-Claims or Send E-Claims.
Enter the User ID and Password established when you signed up to send claims through the EDI Health Group clearinghouse. See Electronic Claim, Signing Up. You only have to enter this the first time you send electronic claims. The program remembers after that.
Click Send.
When the claims have been sent, a message pops up.
Click OK. Then a confirmation message displays, asking whether to update the claim billing. Click Yes. The status is changed to Billed.
Printing Paper Claims
You can print a single claim or a group of claims. To print a group of claims, hold down the CTRL key on your keyboard and click each of the claims you want to print. Be sure the status of all selected claims is the same, and that they are all either electronic or paper claims. Then click Print Claims.
To print all claims marked Ready to Print, click Print Claims.
Single Claim To print a single claim, double-click the claim and, in the Claim Information screen, click Print Claims.
Select Printer in the Print To field.
Choose a claim form. If you forget, the program reminds you.
If you left Print Preview checked in the Choose a Report screen, the program displays the claim(s) for you to look at once again. Click the printer icon to print the claim(s).
In the Print screen, choose the printer to which you want the claims printed. Click OK.
After printing, you are asked if you want the claim marked as printed. Click Yes.
Printing Multiple Claims To print a selected group of claims, hold down the CTRL key on the keyboard and click each of the claims you want to print. Then click Print Selected Claims.
In the Choose a Report screen, be sure Printer is showing in the Print To field.
Choose a claim form. If you forget, the program reminds you.
A Search window displays.
For multiple claims, the claim number(s) appears in the Number Box – just click OK to print your claims. You can change your filters here to limit or expand the claims to print by filling in the range fields. Click any Show all values... check box to include all values of that particular type of data. When finished reviewing your choices, click OK.
If you left Print Preview checked in the Choose a Report screen, the program displays the claim(s) for you to look at once again. Click the printer icon to print the claim(s).
Choose the printer to which you want the claims printed. Click OK.
After printing, you are asked if you want the claims marked as printed. Click Yes.
Printing Claims to a File To print to a file, choose File in the Print To field of the Choose a Report screen.
Instead of a Print Preview option, the program asks for the file name. Enter a name or navigate to a folder and enter a name. Click Print.
If sending multiple claims, a Search screen pops up. (See Printing Multiple Claims above.)
Choose the filters to group the claims, or click the Show all values... box(es) and click OK.
When you get to the Print screen, be sure the Print to File section is marked and accurate. Click OK.
Click Yes to mark the claims as being billed.
Customizing The columns displayed in the Claim list screen are customizable. For example, practices often add the Electronic Primary column. See Customizing a Screen.
In addition, the filters can also be changed -- added to, removed, etc. See Customizing Filters.
Clickable Forms To see clickable forms of claims, click a link below:
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