eServices

Using the eClaims Service

Before using the eClaims Service, you must:

• Set up your insurance companies

• Submit claims to the electronic batch

Following transmission, eServices downloads the following reports:

• eClaims Transmission Summary:Lists all claims transmitted in the current session.

• Transmission Log:Lists all claims from the previous transmission that have been sent to the clearinghouse or payers. Review this report carefully; file processing errors are listed here.

• Account Balance Summary:Displays the current balance and history of your eServices account. Account statements are not mailed, so monitor this report frequently. If your account is overdrawn, you cannot submit claims or statements electronically.

• To avoid interruption of services, you can set up automatic credit card or check payments.

• Statement Audit:Lists the patients whose statements were printed and mailed at the clearinghouse. If an asterisk is displayed next to a patient name, the statement was not printed and mailed; this is typically due to an invalid mailing address.

• Claim Status reports:Include claim status, claim rejections, claim acceptances, and requests for additional information. These reports are generated by clearinghouses and insurance companies.

• Requests for Additional Information and Claim Settlement reports:Consist of messages returned by insurance companies requesting information or indicating that a claim has been paid.

• Some insurance companies send these reports by mail, rather than electronically.

Related Topics

Setting Up Insurance Companies

Submitting Claims

Sending Claims

Suspending and Deleting Claims

Transmitting Claims Automatically

Printing Reports

Using the Real Time Claim Submission Service