Managing EDI Claim Files

The Batch Submission Status screen lists your created EDI claim file batches and shows the number of claims included in each batch, the current Processing Status and the Date Completed. You can click Batch Claim Details to open a list of individual claims included in a batch; see Viewing Batch Claim Details. You can also use this screen to Export EDI files and resend batches.

1. Click Billing Claim, and select Batch Submission Status.

2. Enter search criteria, as needed, and click Search.

   The list updates to display batches that meet the criteria you entered.

3. To open the Batch Claim Details screen and see the claims included in a batch, click the Batch Claim Details link in the Details column.

4. To export the EDI files for a batch, click the drop-down list in the Action column and select Export EDI File. You can only export batches in Ready to Export or Processed status.

5. To retransmit all the claims in a batch to your server or third-party billing clearinghouse, click the drop-down list in the Action column and select Resend All. You can only resend batches in Processed status. The list is updated with the new Date Completed (and new Submitted By information, if needed).

6. To remove a batch from the list, click the X icon. You can only remove batches that are in Queued, Ready For Export, or Processed status.

7. To print the Batch File Processing Report for a batch, click the Batch ID link. See Generating the Batch File Processing Report.

From the Batch Submission Status screen, click Batch Claim Detailsfor the batch you want to view. The Batch Claim Details screen displays for the batch selected. This screen lists all of the claims in the batch. For each claim you can view the claim number, date of the claim, patient name, batch status and claim status. You can filter the list of claims by:

• Batch Status -- choose Batched, Not Batched or All.

• Claim Status -- choose a status from the list or All.

The system also provides a warning notice when one or more claims could not be added to the batch. To view why a claim was not batched, click the claim number, which takes you to the claim processing screen.

Finally, at the bottom of the screen are two buttons:

• Batch Details -- opens the Batch Details screen.

• Batch Submission Status -- returns you to the Batch Submission Status screen.

From the Batch Submission Status screen, click the Batch ID link for the batch you want to display as a Batch File Processing report.

The Select File ID drop-down is used to filter the report to a single File ID. You can also select the Hide Completed Files checkbox, to filter the report to only processing files or clear the checkbox to view all files. The system defaults to hiding completed files.

If the batch includes failed files, an alert displays at the top of the report. Click the button to View Failed Claims. The Batch Claim Details screen displays and includes only the failed files.

The report lists the files in the batch; each file in the list includes the File ID # on the left and the Office ID # and PayerID # on the far right.

The processing status displays below the ID fields and includes three sections: # of Claims Queued, Process (# of # Claims), and the status of the transmission as follows:

• For failed files, the final section is Transmission Failed.

• For processed files, the final section is Transmitted.

• If the file belongs to a batch created using 'Create EDI File' , then the final section is Not Transmitted.

The progress bars are color-coded; if the action is:

• Completed, the bar is green.

• In Progress, the bar is dark and light blue slanting stripes.
• Not Yet Started, the bar is gray.
• Failed, the bar is red. For failed files, a Resend button displays.

Finally, at the bottom of the report are two buttons:

• Batch Details -- opens the Batch Details screen.

• Batch Submission Status -- opens the Batch Submission Status screen.

From the Batch Details screen, you can view and manage individual files in each batch. If a file fails to send, the system tries to resend the file every 24 hours. After 72 hours, failed files are removed and the claims are unlocked. From the Batch Details screen, you can resend the file manually or remove the file to release the lock on the claims.

The screen lists each file, in each batch, currently processing. You can Search the list using the Payer ID, Office, Batch ID, Processing Status and Submission Date fields at the top of the screen. Reset restores the search fields to the default.

For each file, the list includes the following columns: the File ID, Office ID, Payer ID, Batch ID, First Submission date, Latest Submission date, # of Claims, Processing Status, Actions and Remove. You can click on the File ID link to view the File Claim Details screen for that file. When you click the Batch ID link, the Batch Claim Details screen displays and includes all the files in the batch.

In the Actions column, if an action is available, the action displays. For files with the Processing Status of Ready for Export or Processed, the Action column displays a link to Export the EDI File, which downloads and saves the file.

If the Processing Status is Failed, the available action is to Resend.

From the list, you can select the checkbox to the left of a failed file and click Send Selected Files to resend multiple files at once.

You can also click Send All Files to resend all failed files in the list. A pop-up displays asking you to confirm. Click Send to complete the resend.

Finally, you can click the Remove icon (displays in the Remove column for that file) to remove a failed file. This removes the failed file so the system no longer tries to resend and unlocks the claim so you can add it to a new batch.