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Complete the setup required to enable DrCloudEHR to provide billing and claims management functionality. The application's Billing Rules engine, Claim Rules engine, and Contract Manager work together with the Billing Manager and Claims Manager to provide efficient claims processing.
You can use DrCloudEHR to generate and submit claims in HCFA or UB-40 format. You can also generate and submit Detailed Financial Transactions (DFT) in HL7 format.
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Add details for each insurance payer you submit claims to. To submit claims electronically, you must create connections to the medical claims clearinghouses used by the insurance payers to both submit claims and receive payment notifications.
Enable Electronic Submission of HCFA or UB-40 Claims
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To submit HCFA or UB-40 claims electronically to an insurance payer, you must configure an EDI connection to the medical claims clearinghouse the payer uses to process claims.
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- Click the Practice tab.
- In the left-hand navigation menu, click the Administrative tab, and then select Practice.
- Click the X12 Partners link under Practice Settings at the top of the page.
- Click Add New Partner.
- Enter the required information. The information should be provided to you by the clearinghouse.
- Click Save.
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To submit DFT claims electronically to a processor, you must configure a connection to the processor the payer uses to process claims. When you configure the connection, you specify an upload folder on the processor's server. When you submit a claim, DrCloudEHR uploads the DFT message in HL7 format to the folder.
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Enable Electronic Payment Notifications
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