Claim attachments

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drk
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Claim attachments

Post by drk » Thu Oct 15, 2015 1:19 pm

Sorry if this has been answered before, I could not find it.

When submitting a claim, can you actually attach a file, say in PDF, to the claim? I have seen the diagnosis tab under case management where the metadata about the attachment is entered, but can't find a button that says "upload your attachment that goes with this claim# XXX now"

Thanks.

drk
Posts: 155
Joined: Sat Oct 11, 2014 11:40 am
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Re: Claim attachments

Post by drk » Thu Oct 15, 2015 1:27 pm

I have already filled in appropriate codes in EDI Report under the Diagnostics tab - 77 for Report Type code, EL for Report Transmission Code.

Now, I have to generate an X12 formatted PDF file so that I can send it to the clearinghouse along with the claim ... But how? Is it even possible?

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Gavin Walker
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Re: Claim attachments

Post by Gavin Walker » Thu Oct 15, 2015 6:31 pm

Sending PDFs in the claim file is not supported. Will they take Transmission Code AA? Then you can put in the control number whatever it is you need to look up the document and send it to them if it is ever requested.
Gavin Walker
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drk
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Re: Claim attachments

Post by drk » Thu Oct 15, 2015 9:55 pm

I will talk to the payer and try that. It would be nice if Medisoft or RM supported this functionality.

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Gavin Walker
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Re: Claim attachments

Post by Gavin Walker » Fri Oct 16, 2015 3:56 pm

I haven't seen any specs from payers that support they receive claim attachments this way.

amelia136
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Re: Claim attachments

Post by amelia136 » Wed Jan 13, 2016 12:06 pm

I have a question in this topic; I just got off the phone with Anthem blue cross, and they do support submission of electronic attachments. I know about PWK segment, however how can I transmit them electronically with Medisoft? and no I'm not talking about using code EL under the diagnosis tab. I'm talking about the actual attachment and uploading of records. Anthem does not provide any other information, other than if our software does not support electronic transmission of attachments then we need to print them and/or fax them. And if Medisoft or RM does not currently support this functionality, will it be in the near future?

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Gavin Walker
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Re: Claim attachments

Post by Gavin Walker » Wed Jan 13, 2016 4:00 pm

According to Anthem's website, they support attachments by mail. Read this document for instructions: https://www.anthem.com/edi/noapplicatio ... _me,edi_nh

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Gavin Walker
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Re: Claim attachments

Post by Gavin Walker » Tue Feb 09, 2016 11:17 pm

PS, in order to submit claim attachments with Medisoft v19 or higher, you need to submit the claims in ANSI 5010 format using the Revenue Management module that comes with Medisoft. While the module comes with Medisoft, it must be configured to work with your clearinghouse. If you have trouble doing this yourself, you can search this forum - we have posted quite a few topics about this subject. You can also work with your Medisoft re-seller to set this up for you. Or, you can purchase a Medisoft or Lytec Revenue Management setup from our shopping cart. In addition, we can do FREE setups for the following clearinghouses if you are enrolled under us: Trizetto, RelayHealth, Availity, Optum, MCP, and Emdeon.

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