EZ 2000 Manual - Sending and Printing Insurance Claims as a Batch

Send/Print Insurance Claims as a Batch

There are three ways to send claims:
1. Print a single Claim and mail it. 
2. Send a single Claim electronically.
3. Send a claim to a batch that is printed or sent at the end of the day.

Print or Send Claims as a Batch
In the Manage module, click Send Claims.

All claims with the status “Waiting to Send” are listed.   Paper versus e-claim is determined by the setting 'Don't usually send electronically' on the Edit Insurance Plan window. If you have multiple Clinics, you can filter by clinic to send claims from each clinic to a specific Clearinghouse.   You can also use the Custom Tracking filter to filter the list by recorded claim data.  Custom tracking data is entered on the Edit Claim window under the Misc tab. 

Preview: View the selected claim before sending or printing.
Blank: Print a blank claim form.
Print: Print selected claims.
Labels: Print individual labels for insurance carriers.
Send E-Claims: Send all E-Claims, or click the dropdown and select a specific Clearinghouse. If you are using e-claims (X-12 only), you may see missing info in the last column. All missing information must be completed first, then return here to continue.
Get Reports: Retrieve reports from a clearinghouse.

History Grid
After claims are sent, they are moved to the History grid. To filter the list by date range, enter the dates in the From/To fields, then click Refresh. Or click the down arrow to select dates from a calendar. If there was a problem with sending, highlight the claims and click Undo. Click Print to print a list of all sent claims.

Double click on an item to see information about the transaction. (The message text in the screen shot was obscured for privacy reasons.)

If there is ever any need to troubleshoot a sent claim, the full text of the batch is saved here. Most of the text, as well as the fields below, are meaningful only to technical support.

Attachments Sent: Indicates if attachments were sent.
Note: Add a note that will display on the Send Claims window.
Acknowledgment: If the transaction has been acknowledged by the clearinghouse, then that information, including the full Message Text and Date/Time, will show at the right.

Acknowledgments
There are 4 types of acknowledgments.  They are known as X12 formats 997, 999, 277, and 835, listed in the order in which they are received from the clearinghouse. Keep in mind that clearinghouses are not obligated to provide these acknowledgment reports, and that they may choose to return some or all of such reports for some batches and not others. EZ has supported format 997 for years. Support for formats 999 and 277 were added in Version 12.3. In the future, support for the X12 835 remittance advice format will be added (Request #138). For now, 835 reports will show in the Send Claims window as Type TextReport.  More specifically, any report that is not a 997, 999 or 277 will show with Type TextReport. The 997 and 999 are simpler formats that only provide information regarding the status of a batch based purely on formatting and data requirements. When a 997 or 999 are received by EZ 2000, the AckCode column for the rows corresponding to the sent claims within the Send Claims window are set to 'A' for accepted or 'R' for rejected. 

The 277 format contains more detailed status information about the batch sent than a 997 or 999. When a 277 is received, the corresponding etrans rows for the sent claims will have their AckCode column set to 'A' or 'R', but the 277 will also show as a separate row within the Send Claims window and have Type StatusNotify_277.  From within the Send Claims window, if you double-click on a row corresponding to a 277, then instead of seeing the Etrans Edit window you see the following window:

The only information from the above window that gets automatically processed/imported is the claim status column (Accepted or Rejected).

Reports
Reports usually come back from the clearinghouse as files placed in the report path specified in the clearinghouse edit window. They are then automatically imported by EZ 2000 and stored in the database.  The original text file is deleted.  Older versions of EZ 2000 did not store the report in the database, but instead moved the file to an archive folder.  Because of the new way that reports are handled, it is no longer important to always run e-claims from the same workstation.