You can generate and submit DFT claims electronically to a claims processor. When you submit a claim, DrCloudEHR uploads the DFT message in HL7 format to a folder on the claims processor's server.

Configure a Connection to the Claims Processor

Configure a connection to the processor the payer uses to process claims. The information required to configure the connection, including the upload folder location, is provided by the claims processor.

Generate a DFT Claim

You can use the Billing Manager to generate DFT claims for one or more closed encounters. 

Claims are generated based on values set in the corresponding fee sheet. If you have to modify any of the data in the encounter, make your modifications in the fee sheet, which contains the source data used in the claim, before you generate the claim.

You can generate and submit claims from the Billing Manager. However the best practice is to generate the claim in the Billing Manager, and then use the Claims Manager to submit the claim.

Note that you can generate claims only for closed encounters. Billing rules configured in the system are applied when you close the encounter.

1. Click the Billing tab.
2. Click Billing Manager in the left-hand navigation menu.
3. Search for the encounters to be billed. Use filters to restrict results and improve performance.
4. Review each encounter record to ensure it contains the following information required to submit a claim:
   • Primary and secondary insurance and Place of Service (POS).
   • Diagnosis Code (ICD) and Service Code (CPT). 
     Insurance companies compare the two codes to make sure service is correct for the diagnosis.
   • Dollar amount for the service.
     If you need to make changes to the encounter record, make the changes to the fee sheet created for the encounter before you generate the claim.
5. Select the checkbox for a closed encounter in the search results. If the checkbox is disabled, the client does not have insurance, and you cannot generate a claim.
6. Click the Set Bill Type button, and then select DFT from the menu.
7. Click Generate Claim(s). The application generates the DFT claim message.