Manually Sending Individual Claims to Carriers

This section tells you how to manually send individual claims to carriers. Topics include:

Billing a Claim From Claim Search

  1. Open Claim Management. If you're in Front Office, click Claim Management in the top menu bar and select Claim Management.

    Claim Management opens.

  2. Search for the claim you want to bill. For more information, go to Searching for Claims.

    The claim must have the status Ready to Bill.

    If the claim does not have the status Ready to Bill, set the status to Ready to Bill. For more information, go to Setting the Claim Status to Ready to Bill.
  3. In the search results list, locate the claim and select Print New CMS Form (Version 02/12) from the Action drop-down list.

    The claim status changes to Billed, and the CMS 1500 form opens as a PDF in a new window. All of the information that populates the form appears, but you will not see the lines and boxes that are on the form.

  4. Click Print to print the PDF to a CMS 1500 form.
    If you are using Mozilla Firefox with Encompass, modify your browser’s application options to use the external default Adobe Reader instead of the built-in Adobe PDF Viewer to properly print the CMS 1500 form.

    For all browsers you are using with Encompass, select to print the actual size of the CMS 1500 form to properly print it.
  5. Send the printed form to the carrier.

Billing a Claim From Claim Detail

  1. Open Claim Management. If you're in Front Office, click Claim Management in the top menu bar and select Claim Management.

    Claim Management opens.

  2. Search for the claim you want to bill. For more information, go to Searching for Claims.
    If the claim does not have the status Ready to Bill, set the status to Ready to Bill. For more information, go to Setting the Claim Status to Ready to Bill.
  3. In the search results list, locate the claim and click the hyperlink in the Claim # column.

    The Claim Detail screen opens.

  4. Click the Actions drop-down button and select Generate CMS Form.

    The Generate CMS Form window opens.

  5. If you are printing the contents of the CMS 1500 form directly on the pre-printed CMS 1500 form, select the Select if you are using pre-printed Form check box.

    All of the information that populates the form prints, but the lines and boxes are not printed.

  6. Click Bill Carrier.

    The claim status changes to Billed and the CMS 1500 form opens as a PDF in a new window.

  7. To print the PDF to a CMS 1500 form, click Print.
    To ensure that the text is aligned properly on the form, make sure that the Fit to Page or Print to Page Size check box is deselected.
  8. Send the printed form to the carrier.