The following instructions are to use an unintegrated clearinghouse. Your clearinghouse must provide all the necessary information to complete the instructions.
Important Note: Selecting Submit in RevolutionEHR when using an Unintegrated Clearinghouse does NOT send the claims to the clearinghouse. The action of Submit changes the status of the claim to Submit and creates an 837 electronic claim file that downloads to your computer. The 837 files need to be manually uploaded by the practice to the unintegrated clearinghouse to complete the submit process.
- Access Admin > General > Practice Preferences > Practice Claims Preferences.
- In the Configuration section, for the Clearinghouse field, select Local 837 (5010).
- Contact your clearinghouse to complete all required fields. Note: If your clearinghouse is not sure what we mean by field names within the Configuration section, the ANSI segment names are displayed beside each of the field names.
- Billing Location Code: ISA06, GS02, or Loop 1000A NM109.
- Interchange Receiver ID: ISA08.
- Group Receiver ID: GS03.
- Transaction Receiver ID: Loop 1000B NM109.
- Transaction Receiver Name: Loop 1000B NM103.
- Click 'Save.'
- Obtain payer id numbers for each insurance company that you intend to file electronically. The clearinghouse can provide you the payer id list.
- Access Admin > Vendors/Partners > Insurance Companies. See Insurance Company Setup for Claims to complete the insurance company setup.
- Log out and log in to see the changes associated to the setting.
Create 837 Electronic Claim File
Option 1 - Invoice
- Access the Invoice > ensure it is Authorized > Claim History tab.
- For the line item that displays Ready to Submit in the Submit Status column, click the Submit icon . Note: The action of clicking the submit icon creates an 837 file that is downloaded to your computer. Customarily, most computers place this file in the Download folder, however, verify with your IT department if changes have been made to your computer.
Option 2 - Claims Screen
- Access Accounting > Claims. Note: As you access the claims screen, the default view is claims ready to submit for the primary practice location that is assigned to your login.
- Check the box for the line item(s) that you want to submit.
- Click the Actions dropdown menu and select Submit. Note: The action of clicking the submit icon creates an 837 file that is downloaded to your computer. Customarily, most computers place this file in the Download folder, however, verify with your IT department if changes have been made to your computer.
- Secondary Payer Claims: The ability to add primary payer details is not available. Contact your unintegrated clearinghouse for secondary electronic submission options or send a paper claim.
- The E-Claims tab within the Claims screen of the Accounting module is not functional when using an unintegrated clearinghouse.