Claims

Billing / Billing / Filters / Claims Complete the Payor Import

As a new client of CentralReach, you will be asked to complete a payor import file before you begin your implementation. This file will be sent to you by our implementation team. The purpose of this file is to make sure your clients’ insurances are imported to match the correct insurance company in our database so that your claims will be sent correctly.

Please see below for a breakdown of how to populate columns A through I of the payor import:

import

Column A – Insurance Company: Name of the insurance company

Column B – Insurance Plan: Specific plan under that insurance company

Column C through F: Mailing address for that insurance company

Column G – Payor ID: Office Ally payor ID. A payor ID indicates where a claim should be sent. Think of it like the mailing address for an insurance company. So it is very important that this ID is matched up correctly to ensure that your claims are submitted to the right payor. You can locate that ID by going to the Office Ally list here. Do a search for your payor to locate the payor ID. The ID you locate here should go into column G of the import file. If you are not sure of the payor ID, you should contact your payor directly to confirm.

payor ID

Columns H and I – ENR & ERA Enrollment: These columns are referring to whether or not you have to enroll with your payor to submit claims electronically or receive responses electronically. On the Office Ally Payer List in the columns ENR and ERA, this will say Y or N. Please see example below:

enr and era

If either columns have a Y, you will need to complete the proper enrollment forms for that payor. You can find the forms here.

 

Columns J through M – How you are currently billing vs. wish to bill in CentralReach: Please let us know how you are currently billing for these payors and how you wish to bill in CentralReach so we can make sure we achieve these goals.

Billing / Billing / Filters / Claims / Claims / Claims Manager / Files How to Access Claim Export File(s)

To view and access claim paper export file(s):

  1. Navigate to the Billing Module  and select Billing.
  2. Search for the billing entry.
  3. Click the Settings Cog icon on the right hand-side of the billing entry.
    1. If the claim was just generated:
      • Select X Claims Generated (view claims) in the drop-down menu.
      • The claim page will open with the claim details.
      • Click X times  under the Export column
    2.  If the claim was generated more than 15 minutes ago:
      • Select X Claims Exported (view files) in the drop-down menu.

5. The claim export files page will open within the Files Module  displaying the claim file(s) export(s) available for the claim.

6. Click the file you with to view or download under the FileName column.

7. Click the  Download File button, to download the file, or Preview to review the file details.