How Medical Office One is set up to utilize a compatible clearinghouse?
The object of electronic billing is to to submit cleaner claims to payors and to provide faster payment. Moreover to help providers and payors cut the costs involved in processing paper and erroneous claims. The average paper claim payment is 60 to 120 days and payment can be received in 7 to 14 working days. The standard way of submitting claims is to print each invoice onto a 1500CMS form or superbill and submit each through the mail or by fax to the appropriate insurance company associated with each patient.
Medical Office One is set up to utilize a compatible clearinghouse. You cannot send electronically direct to insurance companies. With electronic billing, you prepare claims within Medical Office One the same way you always do as if you are planning to send them in a printed form.
Biosoftworld will not give technical support related to issues with clearinghouses.
With e-billing instead of printing up each claim and sending it off by regular mail you instruct the software to electronically create a “batch” file that has all of the claims in it. This is also described as “printing to a file” function. The file is in a *.txt (text) format, and appears the same as if it were printed onto a CMS form. With this function you create a electronic text file with all of the current invoices in them. It is called a “batch” file because it usually contains more than one invoice for more than one patient. Moreover you are be able to create e-files per patient.
Many billing clearinghouses are able to accept this format for electronic billing. You can contact one of them and test your e-bill text files. Once you have established a relationship with a clearinghouse and have a user name and password provided by them you can proceed to next final step. We highly recommend a company that we have tested in order to set up electronic billing services:
Web: http://www.apexedi.com
Email:
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Phone: (800) 840-9152
Apex will freely answer EDI questions from our customers!
In this step this batch or single file is sent through the Internet to a billing clearinghouse, where it is electronically processed, and the data for each claim is sent electronically to each insurance company.
Detailed instructions:
1. The E-Bill button allows you to create a new electronic billing file of the currently viewed 1500 CMS. This file stored in E-BillFiles subdirectory of installation folder. After creation the Billing Type text box is set to "E-BILLED".
2. The "E-Billing" menu option allows you to create a new electronic billing batch file for all not "E-BILLED" invoices.
3. Filter your claims in Step 1 and proceed to Step 2 WHEN YOU SATISFIED WITH THE RESULTS. When E-Bill button has been pressed, E-Billed box will automatically be set from "Hard Copy" to "E-BILLED". An "E-BILLED" here indicates that this claim should be sent in to the billing clearinghouse for electronic processing. If you have modified a claim after it was sent, and you want to resend it, you may click on “Reset” button to do so. At the end of the process , the file will be named and put on your {installation directory}/EBillFiles subdirectory. This file will contain all of the current claims (described as Hard Copy in current E-Billing Screen) to be sent to the clearinghouse. The name given must be unique, so software gives the file the name “mmddyyyy_mmss.txt”, where “mmddyyyy_mmss” is the current date time of the day. Once the file is saved you can always name it whatever you wish.
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