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Sending Batch Claims

Sending Batch Claims Batch claims processing is an efficient way to handle multiple claims simultaneously in the Claims app. This method simplifies the submission process, especially for claims going to the same payer. H

Sending Batch Claims

Batch claims processing is an efficient way to handle multiple claims simultaneously in the Claims app. This method simplifies the submission process, especially for claims going to the same payer. Here’s a step-by-step guide to sending batch claims, from accessing the feature to successfully submitting your claims.

Accessing Batch Claims

  1. Navigate to Batch Claims: Go to the tools dropdown menu within the Claims app and select "Batch Claims." This is your starting point for batch processing.

Preparing the Batch Claims

  1. Download the Template: Once in the Batch Claims section, download the XLSX template provided. This template is designed to capture all necessary claims information in a structured format.
  2. Fill Out the Template: Enter your claims information into the template. Make sure to refer to the instructions workbook included with the template for field-related guidance. This includes optional fields for service line overrides like diagnosis code, billing code, and charge amount, which all must be accurately filled if used.
  3. Payer Information: If all claims in the batch are for the same payer, the 'payer' field in the spreadsheet is not needed initially. You will select the payer upon upload. However, if the payer field is used, ensure the name matches exactly with the payer's name in the system. To match the payer:
    • Click on the "Payer Matching" menu, located right under the "Download Template" button.
    • Search and select the payer, then type the name as it should appear in your spreadsheet.

Optional Fields

  • Prior Authorization Number: If applicable, include this number for claims requiring prior authorization.
  • Resubmit Claim Control Number: Use this field if you're resubmitting a claim and need to include a control number for tracking.

Uploading and Validating the Batch

  1. Upload the Completed Template: Once filled out, upload your template to the Claims app. The system will validate the data to ensure accuracy and completeness.
  2. Service Line Information: If service line information isn't included in the template, you'll select the applicable billing codes for all claims during this step.
  3. Select Providers: Choose the providers related to the claims you're submitting. This ensures that each claim is correctly attributed to the appropriate healthcare provider.

Review and Send

  1. Final Review: Before sending, review all entered information for accuracy. This includes checking the selected payer, billing codes, and provider details.
  2. Send the Claims: Once satisfied with the review, submit your batch claims. The system will process your submission, and the results will appear in the claims list to your left upon completion.

Best Practices

  • Double-Check for Accuracy: Before uploading, ensure all information is accurate and complete to avoid delays or rejections.
  • Utilize Optional Fields When Necessary: Fill in optional fields like prior authorization numbers or resubmit claim control numbers if they apply to your claims. This information can be crucial for the processing and approval of claims.
  • Monitor Submission Results: Keep an eye on the claims list for the status of your submitted batch. This will help you track progress and address any issues promptly.