Claims will not combine if line items have different service codes, dates, or locations. In an authorization, the “Use Service Location” toggle overrides the default address that is set up in Claim Settings. Therefore, claims will not combine if an address is not the same, or if a service code does not have an address set in the appointment details.

To turn the “Use Service Location” toggle on/off:

1. In an authorization, navigate to the “Authorizations” tab
2. Hover over each of the grouped service codes and click the pencil icon on the right-hand side.
3. In the “General” tab, select the Use Service Location  toggle if all of the service codes in the authorization need it turned on.
   • Or, turn the toggle off if all of the service codes need the toggle off.
4. Once the service location is the same for all codes, the claims will be combined when they are generated.

Click here to learn how to bulk merge claims.

Click here to learn how to manually combine service lines on a claim.

Click here to learn how to automatically combine service lines on a claim.

To export a claim as an 837 File:

1. Navigate to the Claims module and select Claims Manager
2. Select the claim(s) that need to be exported and click the Actions drop-down at the top of the grid
3. Click Export/Download
4. In the “Choose a download” drop-down, select a gateway. The gateway settings will use some fields in the export. 
   • If there are any claims errors, click the Ignore errors checkbox
5. Click Export
6. In the “Claims Export Progress” modal, select download next to the claim(s)
7. Click Download in the “Download The File” pop-up

To generate a TEST claim:

1. Navigate to the Claims module and select Claims Manager
2. Check the box next to the claim
3. Click Actions and select Export/Download from the drop-down menu
4. Select a gateway
5. Click Test claim
6. Select Export

To split claims by Place of Service:

1. Navigate to the Billing module and select Billing
2. Select the billing entries to be split
3. Click the Actions drop-down and select Bulk Merge Claims
4. Click the Split on Place of Service checkbox. The claim will split into one claim per client and per Place of Service
5. Click Start claims generation once all changes have been finalized on the current, bulk-merge screen
6. Once the claims have been processed, they can be submitted. To submit the claims, navigate to Go to claims inbox
7. Select the claims to be submitted. Click the Actions drop-down and select Send to Gateway

DPH EI switched their claim process from a proprietary system to 837. This user guide contains the requirements for creating and downloading claims and reports required by the Massachusetts Department of Public Health Early Intervention (MA-DPH EI).

• MA-DPH Specification User Guide

If you filed a claim, but want to invoice a payor instead, void that claim and generate an invoice.

To delete a claim and generate an invoice:

1. Navigate to the  Claims module and select Claims Manager
2. Select the claims entry you want to void and click  Trash Selected
3. Generate the invoices, by navigating to the Billing module and selecting Billing
4. Filter by the custom date range and client
5. Check all of the entries you want to invoice for
6. Click the Actions drop-down and select Bulk-generate Invoices
7. Choose the invoice you want to generate

Click here to learn more about creating an invoice.