electronic secondary claims

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EHCS
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Joined: Tue Oct 02, 2012 10:34 am

electronic secondary claims

Post by EHCS » Thu Sep 19, 2013 8:42 pm

How do I send secondary claims electronically?? I have read in a couple of other posts that it can maybe only be done through RM. At this point the only thing I use RM for is 835 posting. Otherwise I know very little about it. We use emdeon and all of our claims are sent to a text file and then we upload it to emdeon. I figured out how to have RM pulll over the "ready to send" secondary claims and is says the reciever needs a transaction set, but whenever i assign any transaction set all I get is a bunch of errors when I "send" the claims. All I need is to have it drop to a text file and I am not sure where/what errors they are talking about. We send electronically on a daily basis on primary's by sending them to a text file and them uploading them to Emdeon. Any help would be wonderful.

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Gavin Walker
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Re: electronic secondary claims

Post by Gavin Walker » Fri Sep 20, 2013 11:09 am

It sounds like you need your Revenue Management setup to send electronic claims to Emdeon. Sending secondary claims is a matter of a couple of button clicks and then your secondaries go in the same batch as your primaries. It is kind of complicated to setup Revenue Management if you are not familiar with ANSI 5010 claims. We presently charge $150 to setup the first practice database to submit ANSI 5010 claims to a clearinghouse or direct payer.
Gavin Walker
Walker Tek Solutions, LLC
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fax: 417-763-6386

EHCS
Posts: 122
Joined: Tue Oct 02, 2012 10:34 am

Re: electronic secondary claims

Post by EHCS » Sat Sep 21, 2013 8:53 pm

emdeon can only be uploaded via text file....correct? So sending the primary through revenue manager wouldn't be any different than not sending them, we would still have to send it to a text file...correct? If there is a way to send it to emdeon without having to creat the text file and upload it that would be awesome, but I was always under the assumption that is the only way.

The advantage of doing it all through revenue manager would be that the primary and secondary claims could all be sent at the same time, right?

I'm just trying to make sure I have it straight in my mind.

Also how do you get the primary eob to a company if you send them electronically like that (forgive my ignorance, we have always dropped our secondary to paper but some insurance companies are going to electronic only claims and we are picking up more business and need to be as efficient as possible.

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Gavin Walker
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Re: electronic secondary claims

Post by Gavin Walker » Mon Sep 23, 2013 8:21 am

If you use Revenue Management to generate ANSI 5010 claim files, those are technically "text" files. If you want to automate the upload of the text file to Emdeon, you have to write a script for that. Unfortunately, McKesson won't release the documentation on how to write these scripts, so you are kind of on your own to get a script written.

There are many advantages to use Rev. Mgmnt. to generate claims files. Not only can you send primary and secondary claims all at once, but there is also a claim scrubber, and ANSI 5010 files have error checking built in to them.

With the EOBs, you download them into the appropriate practice's download folder.

EHCS
Posts: 122
Joined: Tue Oct 02, 2012 10:34 am

Re: electronic secondary claims

Post by EHCS » Mon Sep 23, 2013 7:58 pm

ok, thanks....let me talk with my business partner and see what we want to do, I appreciate your info.

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