Manual Section 4 Claim Processing (CP) Claim Processing Electronic Select Short Cut Key (F12) Type in Menu Id: CP and enter The # symbol will generate the next Claim ID Process Type: Proof (This will check the claims for errors but not process them) Claim Form: Electronic Proc Center: Click on the ellipsis and choose Office Ally or NHS from the list of Claim Processing Centers Acct Start Date: Should be left blank Acct End Date: Should be left blank Posted Charges: Needs to be checked Unposted: Needs to be checked Claim Process: Yes Process Claim Types: Leave blank for ALL Process Charges: Leave blank for ALL, to re-process an individual charge id, enter the id in this field Billing Providers: Leave blank for ALL, to process claims for an individual provider, enter the provider id in this field Insurance Companies: Leave blank for ALL, to process charges for a specific insurance company, enter the insurance id in this field Insurance Groups: Leave blank for ALL To process claims click on Process Please note by selecting Claim Type, Charge ID, Billing Provider, Insurance Company, or Insurance Group only the information specified will process and produce a claim. - 122 -
Manual Section 4 Claim Processing Once electronic claims are processed, you will see the detail of all claims and errors if any. Any error will be in red and will give you an error message. From this screen you can go directly into the charge and make your corrections. Once your corrections are done, click on the General Tab to Process the claims. Change the Process Type from Proof to Final Click on Process at the bottom of the screen To transfer the file to the processing center click Yes The following screen will appear, click ok Minimize and go to your Windows Desktop - 123 -
Manual Section 4 Claim Processing Double click on your internet browser e.g. Firefox, Netscape, or Internet Explorer Go to www.officeally.com or www.nethealthclaimservices.com Login with your User Id and Password Click on Upload Claims for Office Ally or Upload Batch for NHS Upload HCFA for Office Ally Click on the button Click on Desktop Click on the Office Ally or NHS Folder Select your most recent batch Click open Now click on Upload You have now uploaded claims to Office Ally or NHS Print the page with the File ID for your records Wait 24 hours and log back into www.officeally.com or www.nethealthclaimservices.com and click on Download File Summary. Print or view your File Summary Report for any errors. - 124 -
Manual Section 4 Claim Processing (CP) Claim Processing Paper Select Short Cut Key (F12) Type in Menu Id: CP and enter The # symbol will generate the next Claim ID Process Type: Proof (This will check the claims for errors but not process them) Claim Form: Paper Proc Center: Should be left blank Paper Form: You have a choice between Old CMS1500 (12/90) or New CMS1500 (08/05) Acct Start Date: Should be left blank Acct End Date: Should be left blank Posted Charges: Needs to be checked Unposted: Needs to be checked Claim Process: Yes Process Claim Types: Leave blank for ALL Process Charges: Leave blank for ALL Billing Providers: Leave blank for ALL Insurance Companies: Leave blank for ALL Insurance Groups: Leave blank for ALL To process claims click on Process - 125 -
Manual Section 4 Claim Processing The Claim Detail Tab will open and list claims to be printed. This will also list errors on the claims if any Correct errors if needed Click on the General Tab Change Process Type to Final Click on Process The following message will appear, Click on Yes to print the claims The Print Preview screen will come up Put claim forms in your printer Click on the Print button - 126 -