Insurance Company Electronic Claims Settings

Configure Electronic Claims Settings

1. Find the insurance company then click the insurance name to open. The General tab of the Edit Insurance Company window opens by default.
2. Click the Electronic Claims tab. The Electronic Claims settings information displays.
3. Select the appropriate settings for the insurance company.
   1. "This payer accepts electronic claims": Click to select or clear the selection.
      Note: When enabled, this option allows the submission of electronic claims for this payer.
   2. Clearinghouse: Click the drop-down arrow and select the clearinghouse the provider/practice is enrolled with for this payer.
   3. Electronic Payer Connection: Used by the clearinghouse to route the electronic claims to the appropriate payer for processing. Click Electronic Payer Connection to search and select the payer connection.
   4. Clearinghouse Payer ID: The payer ID that displays is based on the Electronic Payer Connection selected.
   5. Once the payer connection is selected, review the shaded checkboxes.
      • "Requires authorization or enrollment" indicates enrollment agreements are required for electronic transactions with this payer. If not already completed, submit an enrollment request for this insurance company.
      • "Supports patient eligibility requests" indicates this payer supports electronic patient eligibility requests also known as real-time eligibility checks.
   6. Enrollment Status by Practice section: Applicable for Tebra accounts with multiple practices. This section lists each practice and its enrollment status with this payer.
4. Click Save to record any changes.