For customers utilizing eProvider Solutions (ePS) as your clearinghouse, you can now see in your patient's chart what services (Electronic Claims, ERAs, Eligibility) are available for each payer. If you are not currently enrolled for a service a...
The short answer is, that they can. There are several national payers, such as Aetna, Cigna, Humana, and United Healthcare that keep the same payer ID number across all clearinghouses.
The best source of information is the eP...
If you are utilizing eProvider Solutions (ePS) as your clearinghouse, your claims will now have a pre-scrubbing before being submitted to the payer. This scrubbing will alert you to any missing information or errors in the claim in real time s...
ePS or eProvider Solutions is a clearinghouse that is integrated with DrChrono.
Through the setup process, your implementation specialist will show you how to submit EDI (claims), ERA (explanation of benefits), and eligibility...
What determines a payer’s turn-around time for EDI/claim submissions?
Each payer determines its own turn-around time (TAT) based on its internal processes, requirements, and volume. Each payer’s processing time may change base...
Can claims be submitted and ERA transactions received immediately after submitting the EDI and/or ERA agreement ?
No. The payer will need time to process the paperwork within their processing systems, referred to as the payer t...
One required element when submitting electronic claims is the claim filing indicator code. It identifies to the payer what type of claim is being submitted. When a patient has multiple insurances, it also indicates which payer is primary. ...
An EDI Claim file indicator is a code transmitted on an EDI/837 Claim file that tells the payer whether the primary insurance is Medicare or another commercial payer. It is included on all electronic 837P (professional claims) and 8...
In an attempt to assist providers in ensuring their claims are submitted cleanly and processed without delay, CMS and associated MACs are rolling out a series of Smart Edits. The idea is to identify the error more quickly so it can be correcte...
Before sending your claims to the clearinghouse for submission to the payer, they undergo a scrubbing process. If an issue is identified, the claim will be moved to the "Missing Information" status and populated with the specific error. ...