Electronic Claims Maintenance

To access the Electronic Claims Maintenance window:

Click the Insurance Functions button. The Insurance Functions menu is displayed. Select Electronic Claims.

Select Functions > Insurance Functions > Electronic Claims from the menu bar. The Electronic Claims Maintenance window is displayed.

The Electronic Claims Maintenance window is the main window in which you transmit, view, and print your practice’s electronic claims. The Electronic Claims Maintenance window contains the following sections:

Selection
Enables you to select which batch of electronic claims to view. The Selection section contains the following fields:
- Created — Displays each batch by date and time. The most recent batch is the default.
- Transmitted — Displays the date the batch was transmitted. Pending is displayed if the batch has not been transmitted.
- Transaction Report — Displays the date the Transaction Report was retrieved. If the report has not been retrieved, No Report is displayed.
Options
Enables you to select the type of claims to view in the grid for the selected batch. Options are available only after clicking Edit/View Claims. The Options section contains the following claim options:
- Pending — Displays claims that have not been transmitted.
- Transmitted — Displays claims that have been transmitted.
- Errors — Displays claims that have errors in the batch.
- Removed — Displays claims that have been removed from the batch.
Totals
Lists statistics for the batch. The Totals section contains the following fields:
- Total Claims — Number of claims created in the batch.
- Errors — Number of claims with errors in the batch.
- Removed — Number of claims removed from the batch.
- Transmitted — Number of claims transmitted in the batch.

The following function buttons at the bottom of the window enable you to work with electronic claims:

Transmit Electronic Claims

Transmits the current batch. This button is enabled when the claim batch status is Transmitted: Pending, and there are no errors found in the claim batch. If you use a modem, verify that it is turned on before transmitting the batch.
Retrieve Transaction Report
Retrieves the transaction report from the clearinghouse, if the batch has been transmitted. The report is not available until 24 hours after transmitting. If you use a modem, verify that it is turned on before retrieving the transaction report.
- Before clicking Transmit Electronic Claims or Retrieve Transaction Report, confirm that Reachout, pcAnywhere, HotSync, or other utilities that share a COM port with a modem are closed. If not, you cannot transmit or retrieve.
Print Transmission Report

Prints a list of all claims submitted to the clearinghouse. Prior to transmission, this printout includes any reported errors. After the claims have been transmitted, this report contains claims transmitted, omitting any removed claims. The Transmission report includes the following: batch number, creation date, transmitted date, patient number, name, birth date, responsible party name, relationship, primary carrier name, doctor, total amount, and number of lines transmitted.
Print Transaction Report
Prints the Transaction report for the selected batch. This button is enabled only when the report has been retrieved. This report contains the Transmission Log (list of claims transmitted); Account Balance Summary; Provider Daily Statistics; Provider Daily Summary; and the Daily Acceptance Report by Provider.
- To view batch information, select Print Transaction Report and a valid report with a Retrieved date. OrthoTrac automatically detects and displays reports in text or HTML format.
Edit/View Claims

Views claims associated with the selected batch. If the status is Pending, claims can be changed or removed.
Recreate

When there is a batch-level rejection from the clearinghouse, the Recreate button enables the last batch to be transmitted again. This function should be used only when ALL claims were rejected. Your support representative should verify that it is a true batch-level rejection by the clearinghouse before you select this option.
Close Program

Exits to the main menu.

For information on configuring OrthoTrac to send and receive claim information any time, see Sending and Receiving Electronic Claim Data.