eClaims - Send Button

The Send button at the top left of the eClaims Ability is only available while the Ready Tab is selected. While viewing any other bin in the eClaims Ability, the Send button will be grayed out and pressing it will do nothing. 

When a single eClaim or group of claims is selected within the Ready Bin, the user is able to click the Send button. All claims that are selected within the Ready Bin will be generated into a .CLM file.

If the template is for a non-partner clearinghouse, this file will need to be uploaded manually, using the interface provided by that clearinghouse. 

If the template is for MacPractice's partner clearinghouse, Change Healthcare, the .CLM file that is generated will be transmitted to the clearinghouse when the Send button is pressed.

If the Send button is pressed from the Ready Bin, with no eClaims selected, all claims that are viewable in the Ready Bin will be generated into a .CLM file. If the template is for a partner clearinghouse, the eClaims will also be transmitted to the clearinghouse when the Send button is pressed.

Once the Send button is pressed, MacPractice will drop an alert down to confirm that the user does indeed wish to send the claim. This is to safeguard claims from being sent with a potential erroneous click of the Send button.

 

If the user cancels the send confirmation, claims will all remain where they are. No .CLM file will be created and no claim files will send to a partner clearinghouse. No further prompts will follow.

If the user selects the Send button, .CLM files will be generated. For offices that use MacPractice's partner clearinghouse, Change Healthcare, the claim files will be automatically uploaded to the clearinghouse for processing.

If the user selects Send, a File Transfer Results Window will appear once all files have been generated and/or all claims have been sent. The window will display the number of claims that have been sent and will display the transfer protocol stages. At the end of the transfer protocol stages, the window will display whether the claim send failed or was successful.

 

There are occasions in which multiple claims may be written into separate .CLM files. If multiple claims have batched into multiple files, a File Transfer Results Window will appear for each file that was generated. Each window will display the results of each file individually.

The only option to select within the File Transfer Window is "OK".

Receive Reports

Once the user clicks OK in the File Transfer Results Window, the window will disappear. If the office uses a non-partner clearinghouse, the steps end here. If the office uses MacPractice's partner clearinghouse, Change Healthcare, a Receive Reports prompt will appear. At this time, the user can opt to Receive or Cancel.

If the user chooses to receive reports, MacPractice will download any available reports that are waiting at the clearinghouse, and will apply their Accepted and Rejected statuses to all claims associated to a report. Depending on how many reports are awaiting download at the clearinghouse, it may take some time for reports to download and apply to claims.

If the user chooses to cancel the Receive Reports window, MacPractice will take no action to download reports from the clearinghouse. If the user wishes to download reports later, they will either need to send more claims and wait for the prompt, or they will need to manually receive reports.

 

 

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