Insurance Company Electronic Claims Settings
Updated: 11/30/2023 | Views: 8012
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To submit claims electronically, the practice must first be enrolled in electronic claims services. Once enrolled, you can configure the Electronic Claims settings for the insurance company.
Configure Electronic Claims Settings
- Find the insurance company then click the insurance name to open. The General tab of the Edit Insurance Company window opens by default.
- Click the Electronic Claims tab. The Electronic Claims settings information displays.
- Select the appropriate settings for the insurance company.
- "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.
- Clearinghouse: Click the drop-down arrow and select the clearinghouse the provider/practice is enrolled with for this payer.
- 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.
- Clearinghouse Payer ID: The payer ID that displays is based on the Electronic Payer Connection selected.
- 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.
- Enrollment Status by Practice section: Applicable for Tebra accounts with multiple practices. This section lists each practice and its enrollment status with this payer.
- Click Save to record any changes.